Tuesday, November 4, 2008

Using Zinc to Boost Ritalin's Effectiveness

We have seen that combining stimulant and non-stimulant medications for ADHD can be effective, as evidenced in a previous post on how Risperidone boosts ADHD stimulant medication effectiveness. We have also explored how supplementation with the amino acid tyrosine can boost the effectiveness of clozapine. Now we will be examining another non-medication compound, zinc sulfate and its effects on the popular ADHD drug methylphenidate (Ritalin, Concerta).

Most of the information in this post is gleaned from a 2004 article in the journal BMC Psychiatry on Zinc Sulfate and methylphenidate for children with ADHD. Some key points are listed below:

  • The study compared children with ADHD of both genders, ages 5-11 who took either: methylphenidate with zinc sulfate (15 mg zinc) to those who took methylphenidate by itself (with a sugar placebo) for 6 weeks. Results on treatment effectiveness were determined based on both parent and teacher ratings for ADHD behaviors, as well as psychiatrist evaluations every 2 weeks.

  • Zinc is required for the proper function of over 100 different enzymes in the body and previous research has shown that a deficiency in this important mineral can be associated with ADHD.

  • Zinc also helps regulate levels of the important compound melatonin, which plays a significant role in regulating sleep patterns in individuals both with or without ADHD. Melatonin also plays an important role in regulating levels of the brain chemical dopamine, which is a key factor in ADHD.

  • All children in the sample were of the combined subtype (one of the 3 major subtypes of ADHD, which includes hyperactivity, impulsive behavior and inattention), and had not received previous ADHD medications.

  • The study found that ADHD symptoms decreased following the 6 week period for the methylphenidate group, but an even more pronounced decrease in negative symptoms when the methylphenidate was combined with zinc. These trends were statistically significant in both the parent and teacher rating studies.

  • (Blogger's point, not from article): Based on previous studies and blog posts on the ADHD stimulant medication Adderall, we have seen that psychiatrists generally see even greater levels of improvements for ADHD treatments than do parents or teachers. If this trend holds true to this treatment, then it is possible that these positive effects may be under-representations of the real potential of zinc-methylphenidate combination treatment.

  • (Blogger's remark, not from article): While this study showed promise, it did not compare zinc-methylphenidate treatment to zinc treatment by itself. In other words, we cannot tell if zinc treatment actually amplifies the effects of the medication or if it simply targets additional symptoms of the disorder. Given the fact that zinc deficiency is common in individuals with ADHD, it may be the case that zinc supplementation, not methylphenidate may be the main effective treatment factor. Look for future posts on zinc supplementation and ADHD.

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Anonymous said...

It is possible that zinc may work by depressing the level of copper. Excess copper appears to selectively oxidate the phospholipid, phosphatidylethanolamine, among other things. This has gotten a lot more attention in autism then in ADHD.




The ADHD Treatment Guide said...

Thanks, that's definitely a possibility worth investigating. I was not aware of that!

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