Original Article

Neuropsychopharmacology advance online publication 23 August 2017; doi: 10.1038/npp.2017.160

Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: a Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies

Jane Pei-Chen Chang1,2,3, Kuan-Pin Su1,2,3,4, Valeria Mondelli1 and Carmine M Pariante1

  1. 1Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
  2. 2Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan
  3. 3Department of Psychiatry, College of Medicine, China Medical University, Taichung, Taiwan
  4. 4Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan

Correspondence: Dr JP-C Chang, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, The Maurice Wohl Clinical Neuroscience Institute, G.33.72, Cutcombe Road, London SE5 9RT, UK, Tel: +44 (0)20 7848 0531, Fax: +44 (0)20 7848 5408, E-mail: peko80@gmail.com

Received 28 April 2017; Revised 3 July 2017; Accepted 18 July 2017
Accepted article preview online 25 July 2017; Advance online publication 23 August 2017



The role of omega-3 polyunsaturated fatty acids (omega-3 or n-3 PUFAs) in the pathogenesis and treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD) is unclear. A systematic review followed by meta-analysis was conducted on: (1) randomized controlled trials (RCTs) assessing the effects of n-3 PUFAs on clinical symptoms and cognition in children and adolescent with ADHD; and (2) case–control studies assessing the levels of n-3 PUFAs in blood and buccal tissues of children and adolescents with ADHD. In seven RCTs, totalling n=534 randomized youth with ADHD, n-3 PUFAs supplementation improves ADHD clinical symptom scores (g=0.38, p<0.0001); and in three RCTs, totalling n=214 randomized youth with ADHD, n-3 PUFAs supplementation improves cognitive measures associated with attention (g=1.09, p=0.001). Moreover, children and adolescents with ADHD have lower levels of DHA (seven studies, n=412, g=−0.76, p=0.0002), EPA (seven studies, n=468, g=−0.38, p=0.0008), and total n-3 PUFAs (six studies, n=396, g=−0.58, p=0.0001). In summary, there is evidence that n-3 PUFAs supplementation monotherapy improves clinical symptoms and cognitive performances in children and adolescents with ADHD, and that these youth have a deficiency in n-3 PUFAs levels. Our findings provide further support to the rationale for using n-3 PUFAs as a treatment option for ADHD.

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