St. John's Wort and ADHD
Some parents have concerns about using stimulant medications to treat ADHD in young children. Parents sometimes feel these medications have too many side effects, including concerns about dangerous effects to cardiac health and may be worried about the potential for these medications for being abuse. Also, there is a fair percentage of children for whom stimulant medications do not improve the symptoms of ADHD. Families may turn to herbal supplements to help treat this disorder.
Herbal medications or ‘botanicals’ have an important place the practice of good medicine. Several medications used regularly by doctors around the world to treat a variety of disorders ranging from high blood pressure to cancer were first discovered in plants. St. John’s Wort (hypercium perforatum) has been thought to treat a wide variety of psychiatric disorders, and there is some evidence that it can help lessen mild symptoms of depression. An article just published in the Journal for the American Medical Association suggests that St. John’s Wort is not helpful in treating children with ADHD.
This study by Dr. Weber and colleagues examined the impact of a standardized formulation of H perforatum product in 27 children with ADHD compared to 27 children with ADHD receiving a placebo. Participants were evaluated over the course of 8 weeks and the authors concluded that H Perforatum did not improve ADHD symptoms in these young people.
It is possible that a different formulation of St. John’s Wort may have shown some benefit in improving symptoms of ADHD, but it’s hard to endorse this particular herbal medication when there are so many other medications that have been repeatedly shown to work in treating the illness in children, teenagers and adults. Not only is there little evidence that St. John’s Wort helps, other research shows that there may be potentially dangerous interactions between this botanical supplement and prescribed medications.
St John’s Wort is known to increase the breakdown of other medications, including certain sedative medications, and may reduce their effectiveness. It’s even been shown to cause some complications with anesthesias used during surgery. Certain oral contraceptives are known to be less effective if St. John’s Wort is used, and it’s been suggested that there are more unintended pregnancies and break though bleeding when the botanical is used with certain contraceptives.
It seems like there isn’t enough research to justify the use of St. John’s Wort in treating ADHD, especially before standard treatments have been tried. However if you decide to use St. John’s Wort or give it to your child, please tell your doctor so they can consider interactions with other medications. As always, I welcome your comments and questions on living with ADHD.
Paul Ballas, D.O., wrote about mental health for HealthCentral. He is a member of the American Psychiatric Association and has been a presenter at the American Psychiatric Association and American Academy of Psychosomatic Medicine meetings.