There are many treatments available for attention deficit hyperactivity disorder (ADHD). But for various reasons, the treatments available — medication or psychotherapy — aren’t going to work for everyone who tries them.
That’s why over the past few years, we’ve seen the growth of the micro-nutrient industry. Micro-nutrients are usually a proprietary blend of vitamins and minerals purported to help with various symptoms. One such micronutrient blend is called EMPowerPlus, and purports to treat a range of conditions. Its website claims that EMPowerPlus has been “proven effective in reducing or eliminating the symptoms of bipolar, anxiety, depression, and ADHD.”
So how effective is EMPowerPlus in the treatment of ADHD?
Three years ago, I wrote about the weak research that supported this micronutrient’s use in the treatment of bipolar disorder, depression, and ADHD. In noting research that supported its use for these concerns, the manufacturer cited letters to the editor of medical journals in the same breath as peer-reviewed research.
These kinds of hyperbolic claims are usually the first red flag I look for when evaluating a new drug or product.
But a new study was just published that allayed some of my previous criticisms of EMPowerPlus, especially the most important one — the lack of a placebo-controlled trial.
That trial has been completed and the results of that study published in the British Journal of Psychiatry by Rucklidge et al. (2014). In a double-blind, randomized controlled trial, 80 adults with ADHD were assigned to either take micronutrients for 8 weeks or a placebo pill.1 Measurements of ADHD symptoms (among other symptoms) were made at the study’s onset, and at the end of 8 weeks.
Nearly 65 percent of those in the micronutrient group showed a 30 percent drop on at least one of the ADHD’s measurement’s subscales. This was compared to 37 percent of the placebo group.
The researchers sum up their findings:
[P]articipants taking the micronutrient formula reported greater improvement in both inattention and hyperactivity/ impulsivity compared with those taking a placebo. Improvement in hyperactivity/ impulsivity was also noted by the observers.
The only hiccup in the study was that the clinicians — who were blind to the treatment each participant were receiving — didn’t find the differences in ADHD symptoms that both the individual participant and the observer saw:
Clinicians did not observe group differences on the [primary outcome] ADHD rating scales or the LIFE-RIFT scale, but reported greater global functioning improvements based on the GAF, CGI-I-ADHD and CGI-I – Overall Impression.
Both self-ratings and observer ratings (that didn’t come from an objective observer, but from a family member, partner or friend) are considered somewhat subjective. Clinician ratings, on the other hand, are considered more objective. The researchers make some rational arguments why clinician ratings in this study may have been conservative.
The researchers don’t know the mechanism of action for EMPowerPlus, which apparently includes every vitamin in the alphabet (but K), as well as 16 minerals. In the blood tests they ran, they only found significant differences between the two groups in their levels of Vitamin D, B12 and folate. They also found the safety marker prolactin was elevated in the micronutrient group.
However much you want to dance around it then, the findings from this placebo-controlled randomized trial are a little mixed. While demonstrating a significant decrease in ADHD symptoms in self-report and observer ratings, the micronutrient found no such decrease amongst clinicians who rated the participants on their ADHD symptoms at the end of 8 weeks.
Micronutrients like this require taking a lot of them in order for them to do their work, and the cost may actually be more expensive than some medications (since insurance generally won’t cover this treatment, while insurance may cover the majority of the cost of a prescription medication). The long-term effects of taking such high doses of some vitamins and minerals are unknown — and some research suggests it could actually increase your mortality rate. And its legal status in the U.S. is less than clear.2
But now there’s some good, objective evidence from an randomized controlled trial that suggests taking such micronutrients may be helpful in the treatment of attention deficit hyperactivity disorder in adults. We need further research to verify these results and expand upon them, but it’s a good start for this micronutrient.
Rucklidge, JJ, Chris M. Frampton, CM, Gorman, B., Boggis, A. (2014). Vitamin–mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial. The British Journal of Psychiatry, 1–10. doi: 10.1192/bjp.bp.113.132126
- None of the participants were on an ADHD medication while in the study. [↩]
- The U.S. Food and Drug Administration (FDA) doesn’t allow any dietary supplement like EMPowerPlus to be marketed “in the treatment, prevention or cure of a specific disease or condition.” You should be aware that when a company violates such restrictions, they could face regulatory action from the agency. The company doesn’t seem to care since it’s based in Canada, but it’s something to be aware of. [↩]