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Posted by on Apr 15, 2014 in Medicine, Mental Health, Parenting, Pseudoscience, Psychology, Skepticism, Teaching | 27 comments

Alternative Medicine Treatments for ADHD (and why they are bunk)

This post is part of a series of guest posts on GPS by the graduate students in my Psychopathology course during Spring 2014. As part of their work for the course, each student had to demonstrate mastery of the skill of “Educating the Public about Mental Health.” To that end, each student has to prepare two 1,000ish word posts on a particular class of mental disorders, with one of those focusing on evidence-based treatments for those disorders and the other focused on a particular myth or misunderstanding about mental illness.

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Alternative Medicine Treatments for ADHD (and why they don’t work) by Hunter Holder

Attention Deficit/Hyperactivity Disorder (ADHD) is a mental disorder that is characterized by inattention, hyperactivity, and impulsive behavior. Like many mental disorders, ADHD is very treatable. Many decades of empirical evidence has shown that with pharmacological treatments, psychotherapy, or a combination of the two, adults and children diagnosed with ADHD can have fairly typical lives. In fact, there are several options available for each kind of treatment because some medications may be harmful to certain individuals or some therapies may be more suitable for some than others. However, in an age where doctors, therapists, and big medicine are endlessly perceived as the bad guys that can’t and shouldn’t be trusted, there are alternative treatments as well. Things like chiropractic medicine, acupuncture, and message therapy. Naturopathic “doctors” even suggest that things like herbs, homeopathic medicine, and supplements can cure the symptoms of ADHD, citing that natural remedies “add more to the healing process” than western medicines.

A lot of the proponents of these alternative treatments promote them by stating that the side effects of recommended medication are too dangerous or that the medications themselves are intrinsically unsafe. While it is true that all medications have side effects and can be potentially dangerous, the primary medications for ADHD (commonly known as Ritalin and Adderall) have far more benefits than disadvantages. In fact, along with behavioral treatment, they are the most effective treatments available. Nevertheless, in an age where “all natural” and alternatives reign among the general population, people still buy in to the atypical treatments out there. This begs the question: do these treatments really work?

(Note from Dr. Lack – this sort of thing makes me so angry that I literally want to punch someone. Maybe this guy in the blue shirt, for instance.)

The American Chiropractic Association (ACA) recommends that children and adults diagnosed with ADHD be treated by chiropractic medicine. The organization makes some pretty typical pseudoscientific claims. First, they make claims that there is something wrong with the disorder itself. They claim that perhaps some kids just can’t learn some subjects as well or others and that some teachers just don’t know how to teach these kids in a way that they can understand. This is somewhat misleading because while ADHD can certainly hinder learning and academic performance, the disorder itself is not a learning disorder. Second, they claim that the diagnosis is invalid and that it is based on a questionnaire. In reality, diagnosis is a longitudinal process that comes from assessment, observation, and interviews or reports from teachers and parents. Third, they claim that the treatments with actual evidence supporting them are insufficient because they do not cure the disorder. However, it is well understood that pharmacological treatments for most mental disorders are for short-term benefit and long-term results are far more likely to come from behavioral therapy. It is also understood that ADHD isn’t something that can be cured in the same way that a bacterial infection can. The organization goes on to say things that imply that they are the ones focusing on the source of the problem, which they claim is lack of postural muscle development (the exact cause of ADHD is fairly unknown and is likely caused by several factors), instead of just the symptoms like trained mental health professionals do. Finally, the organization makes what may be one of the most defining traits of pseudoscience, anecdotal claims that their treatment works as good or better than western medicine. Of course, they are claims that have no actual experimental empirical evidence.

Perhaps someone is looking for alternative treatments for ADHD in their child because the child had an adverse reaction to Ritalin. If they found themselves at the ACA website, they would probably believe that this treatment is a viable option. The website overall is very official looking, they use big words like “chiropractic neurologist” and “musculoskeletal imbalance”, and all of the evidence and claims come from so-called doctors. Plus, who hasn’t heard of going to the chiropractor to get your back cracked? Maybe they could help with this too. In reality, these people should look to a clinical psychologist or psychiatrist because there are plenty of other options besides Ritalin, both pharmacological and psychological, to effectively treat ADHD. However, they may not because they have read the negative things that the ACA has to say about the effective medications. In reality, chiropractic medicine could never treat ADHD or even help with symptoms more than a placebo could. As a whole, chiropractic medicine is nothing more than a pseudoscience that was created by a grocer and, to be honest, a scam, and a dangerous one at that. There is no empirical scientific evidence to support the use of chiropractic medicine as a treatment for ADHD or, for that matter, any other ailment that it may claim to treat except for back pain possibly.

The same case could be made for the number of other alternative treatments that are available for ADHD. Things like acupuncture and homeopathy have their basis in pseudoscience as much as chiropractic treatments do. Acupuncturists claim that their form of therapy is the ideal primary treatment for children suffering from ADHD. In fact, acupuncture has not been shown to provide anything more than a simple placebo effect. Proponents of homeopathic medicine make the same claims. They say that western medicines like Ritalin and Adderall are too dangerous and that their treatment is far more desirable. In reality, homeopathic medicine is absurd. It is based on the concepts “like cures like” and “less is more” (sounds ridiculous already, huh?). So those that create homeopathic medicines take a substance that they believe would normally cause the ailment (e.g., poison ivy oil for an itch) and then dilute it over and over again. When then finished product hits the shelves, it is nothing more than a ridiculously overpriced (and lucrative) dropper full of water.

It’s important to stay aware of these kind of pseudoscientific treatments not just for ADHD, but for any illness. Researching and having a skeptical mind is key to finding out if what you’re doing is actually accomplishing something or if you’re just wasting your time and money. There are plenty of resources out there that take these kinds of subjects, break them down, and get to the truth about their effectiveness and validity. However, if something is called alternative medicine, it probably doesn’t really work. Alternative medicine that works is just called medicine.

  • saijanai

    EEG power ratios of theta/beta has been established as highly correlated with ADHD in kids and there’s even an FDA-approved test for ADHD based on detecting an abnormally high ratio: http://www.fda.gov/newsevents/newsroom/pressannouncements/ucm360811.htm

    Both mindfulness and Transcendental Meditation practice have been found to reduce the EEG theta/beta power ratio in kids with ADHD, as well as to reduce anxiety and other symptoms associated with ADHD.

    [the question of which form of meditation is better for which types of people with ADHD awaits well-desiigned head-to-head studies comparing the two therapies -not holding my breath on that one as meditation researchers generally refuse to test anything other than their own favorite style of meditation]

    Does meditation practice for the treatment of ADHD fit the definition of alternative medicine treatment?

    • http://adhdcommunity.boards.net/ Amtram

      EEG is not yet considered an adequate diagnostic tool, according to the American Academy of Pediatrics, it’s just been approved for clinical testing to see the results on a larger scale.

      As for mindfulness meditation, results with people who are on the Hyper or Combined spectrums are not terribly good. You see, you have to be able to turn off the brain chatter, and that takes a really, really long time, and ADHD makes you tend to want to give up if you go too long without noticeable success. Plus, once you get the hang of it, you have to remember to do it every day, because once you stop doing it, it stops working. Sticking to a schedule – also not a strong suit with ADHD.

      It can be beneficial in other ways, but it’s not going to help ADHD nearly as much as finding the right medication. In fact, if you get the right medication, it might finally make it possible for you to practice mindful meditation.

    • http://www.caleblack.com/ Caleb W. Lack

      As I replied on r/skeptic, NEBA is a supplementary tool that (at least based on the study the manufacturer did) adds incremental validity to diagnoses when combined with more traditional types of assessment. Much more research needs to take place, by someone not affiliated with the manufacturer.

      As far as meditation, I think this Cochrane review (http://www.ncbi.nlm.nih.gov/pubmed/20556767) sums up quite nicely my stance on the current literature:

      “As a result of the limited number of included studies, the small sample sizes and the high risk of bias, we are unable to draw any conclusions regarding the effectiveness of meditation therapy for ADHD. The adverse effects of meditation have not been reported. More trials are needed.”

      • http://adhdcommunity.boards.net/ Amtram

        I hate, hate, hate “more trials are needed,” especially when it’s patently clear that they are not. It’s at the end of every abstract from a chiropractic or naturopathic “journal” and every study of acupuncture, homeopathy, or reiki.

        • http://www.caleblack.com/ Caleb W. Lack

          Sometimes more trials are needed, though, especially when initial trials are poorly conducted or underpowered. In the examples you cite, however, the literature is pretty clear :)

  • http://adhdcommunity.boards.net/ Amtram

    OMG, I so wish that I could post this on a particular ADD forum that avidly promotes this sort of woo, but instead I will share it on http://adhdcommunity.boards.net/, which I started to counter the pseudoscience of the other forum. And twitter. And facebook. Because it can’t be said enough. And if you want, I can tell you a whole bunch of other things they say will work at that first place if only so you can point and laugh. . .

    • http://www.caleblack.com/ Caleb W. Lack

      Unfortunately, I’m afraid that I’ve likely heard them all. The sheer amount of woo and nonsense that gets peddled to parents of kids with problems like ADHD or autism is infuriating. Thanks for sharing the evidence-based stuff around!

      • http://adhdcommunity.boards.net/ Amtram

        Tell me that you’ve heard of crawling therapy, and I’ll believe you! Heh.

        • http://www.caleblack.com/ Caleb W. Lack

          Well, you’ve got me there. Crawling therapy?

          • http://adhdcommunity.boards.net/ Amtram

            Oh, snap! Yes, you see, infants who don’t crawl for long enough have missed a crucial part of brain development – but it’s never too late! Even adults can regain what they lost by crawling around on all fours (with the supervision of a trained crawling therapist, of course!) And kids with ADHD and autism tend to dislike crawling because they don’t like being on their bellies on the floor. So obviously, they need to catch up in order to cure their conditions.

            The more you know. . .

          • http://www.caleblack.com/ Caleb W. Lack

            I feel much like my father must have, when during his first viewing of the movie “Elf,” this scene came up:

            http://youtu.be/Fig956-MuVA

            He literally threw his hands in the air, exclaimed “Gawdammit!” and walked out the room.

          • http://adhdcommunity.boards.net/ Amtram

            Well, I did share this over there, which will probably get me in trouble because it conflicts with the dominant paradigm. I hope it does not attract too many woo proponents to the conversation, but it had to be done.

          • http://www.caleblack.com/ Caleb W. Lack

            Let them come with their anecdotes and nonsense!

          • http://adhdcommunity.boards.net/ Amtram

            They don’t allow outside links to “commercial” sites – you advertise a book here. Now, if that book were about the paleo diet, they might let it slide. . .so I used your title, your blog name, removed all the links from the text. . .dedicated people will find it. But I’ll forward you any responses that are particularly amusing!

          • http://www.caleblack.com/ Caleb W. Lack

            That sounds great, thank you :)

          • http://adhdcommunity.boards.net/ Amtram

            So far all we’ve got is “But it worked for me!”

          • http://adhdcommunity.boards.net/ Amtram

            I can’t even. Here. All I can do is let you see for yourself: http://www.addforums.com/forums/showthread.php?t=160894

          • http://www.caleblack.com/ Caleb W. Lack

            “Arguing with those who have denounced the use of reason is like administering medicine to the dead.” – Thomas Paine

          • http://adhdcommunity.boards.net/ Amtram

            I know – and yet I still do it. I guess I’m inherently masochistic. At least I schooled them on epigenetics.

  • http://adhdcommunity.boards.net/ Amtram

    Here’s the thread I have dedicated to giving you some well-deserved traffic. I hope it works: http://adhdcommunity.boards.net/thread/141/read-article-on-alternative-treatments?page=1&scrollTo=381

    • http://www.caleblack.com/ Caleb W. Lack

      Aw, thanks, that’s very nice of you. We’ve had a pretty good flow since it came up, thanks to shares and reddit posts, and this will be very helpful!

  • Grace

    Dear author,
    Given the increase in the use of non-traditional remedies for ADHD, I found your post to
    be timely and provocative. First, with regards to your statement that “if
    something is called alternative medicine, it probably doesn’t work,” allow me
    to note that some have shown significant therapeutic potential. For instance, a study led by Dr.Andrew Vickers proved that acupuncture is successful in relieving chronic pain and alleviating migraines. Second, while you group chiropractic and acupuncture into one
    category, let me call attention to the fact that the latter may be more
    effective. I agree with you that the American Chiropractic Association (ACA) makes several skeptical remarks that are not supported by evidence, including the statement that the disorder is caused by a “lack of postural muscle development.” Research conducted by the National Institutes of Health indicates that the brains of individuals with ADHD show a delayed maturation by three years in regions involved in thinking, paying attention, and planning. Though the exact cause of the neuropsychiatric condition remains unclear, my judgment is that it is more genetic and neurological, rather than muscular, as claimed by the above-mentioned organization. In addition, I applaud you for acknowledging that
    the diagnosis requires a “longitudinal process.” According to the DSM-V criteria, individuals must show six or more symptoms of inattention or hyperactivity for at least six months for physicians to conclude that they have ADHD. Thus, the ACA’s argument that the process of arriving at the diagnosis is invalid suggests that it lacks a holistic understanding of the illness.

    However, unlike chiropractic, many parents including Karaszi, report improvement in their
    children’s behavior after they receive acupuncture. Though the mechanism of action
    remains unknown, literature suggests that it works through a placebo effect and improved body circulation. Ellison notes that spending quality time with her son during weekly meetings could have also contributed to the reduced hyperactivity and better focus. With regards to the question you raise on whether the aforementioned treatments really work, my response is, does it matter? I agree with you that these complementary options
    lack randomized, control trials that demonstrate their effect, but this does not mean that they do not necessarily work. If parents observe positive change and there are no adverse side effects, I argue that the natural remedies can and should be used. Furthermore, the highly personal nature of acupuncture as well as the wide array of types renders it difficult for scientists to conduct a large-scale experiment demonstrating its benefits. This is the case for neurofeedback and many other natural options as well. Thus, nonconventional cures may never become “evidence-based treatments,” but this should not hinder their
    use, provided that their organizations do not make blatant pseudoscientific
    claims. For alternative medicine, subjective report of improvement should
    qualify as a legitimate indicator of treatment effectiveness. So, what is at
    stake if patients continue to rely on Ritalin as the primary means of coping?
    Children as young as three years old will become dependent on the drug. However,
    natural options offer something Western medications cannot provide; when patients
    take the time to go to therapy sessions and do their best to control their brain
    activity during neurofeedback, they will realize that there is something they
    can do and learn to overcome ADHD step by step. Alternative medicine may be
    alternative, but it is still medicine nonetheless.

  • Laura Marie Roberts

    I am so excited to have found this article! My son is turning 21 and has terrible ADD! He has a wonderful job, and if his father doesn’t wise up to our sons need for Western Medicine” to give him the attention needed for his job, he will be out of a job! But no. Even after our sons boss told him he needs to slow down and think before he does stuff, the Ex is finally convinced, but doesn’t want our sons brain controlled by chemicals. “Mind control” he calls it. He’s looking into homeopathic alternatives. smh

    • http://www.caleblack.com/ Caleb W. Lack

      Well, the homeopathy nonsense certainly won’t do much, even if it is “natural” (and by natural, I mean “water”). I hope he can find some help and improve his quality of life. ADHD can be very, very problematic in the workplace.

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