St. John’s Wort Not Effective in Treatment of ADHD

As many as 4 million Americans, approximately 2 million of them children, suffer from Attention Deficit Hyperactivity Disorder (ADHD), a condition that hinders the ability to control their behavior or focus their attention. It is estimated that 3 to 5 percent of children in the U.S. suffer from this condition, meaning that in a classroom of 25 to 30 children, it is likely that at least one will have ADHD.

Many people suffering from ADHD were prescribed such stimulants as Adderall, Ritalin and Concerta, but in 2006 the FDA issued warnings that these prescription drugs could cause sudden death, heart attacks, and hallucinations. With these potential dangers in mind people began to turn to alternative medicine with botanical therapies—St. John's wort clearly being the #1 choice—but parents also reported using ginkgo biloba, echinacea, and ginseng for treatment of hyperactivity or depression.

Though the trials were small, new studies show that St. John's wort is no more effective than a placebo against treating ADHD in children. At the Bastyr University in Kenmore, Washington, 54 children, ages 6 to 17, were randomly given either rice protein placebo pills or St. John's wort for eight weeks. "We saw no treatment benefit at all from St. John's wort," said Wendy Weber, a naturopathic doctor at Bastyr and the study's lead author.

Dr. P. Murali Doraiswamy, chief of biological psychiatry at Duke University, called the study "a wake-up call" to stop treating children with untested remedies—about ninety-nine percent of herbals are still unproven. St. John's wort interferes with about half of all drugs, mainly by flushing them out of the body quickly and thus reducing their effectiveness.

Dr. Eugenia Chan, director of the ADHD Program at the Developmental Medicine Center at Children's Hospital Boston, cautions that parents need to be as critical of complementary and alternative medicines as they are about conventional drugs. People often accept herbs and dietary supplements as being safe because they seem natural, without questioning their actions or side effects. All authorities agree that if one is interested in using alternative and complementary medicine, that you seek a physician who is knowledgeable in this area, and willing to work with you prior to starting treatment.

Despite the latest negative finding, St. John's wort, once hailed as "nature's Prozac," may still have a future in the treatment of ADHD—further research focusing on the key active agents in St. John's wort, hypericin or hyperforin, will be necessary. Also the dosages used in this study were small (300 mg).

Funding for the study was provided by the National Center for Complementary and Alternative Medicine and the findings are published in the June issue of the Journal of the American Medical Association.