Recently, an article in
ADDitude magazine's online site recently recommended pycnogenol as a possibly
helpful herbal supplement for the treatment of ADHD. Pycnogenol is a proprietary extract of the
bark of the French maritime pine. It has
been tested as a potential treatment for many conditions due its antioxidant
properties. How good is the evidence for
ADHD?
Effectiveness
Pycnogenol has been evaluated in a number of trials in
patients with ADHD. Most of these trials
have measured various substances which reflect oxidative stress, and most of
them have shown decreased oxidative stress.
However, it isn't clear that oxidation is definitely a cause of
ADHD.
There are two trials which measured ADHD symptoms in
response to pycnogenol. One trial was a placebo
controlled, blinded study which involved 61 children with ADHD. This means that only around half of the
children took the actual study drug. This study showed pycnogenol to be helpful in
reducing ADHD symptoms, but the numbers are not big enough to be statistically significant. The second trial involved 24
adults in a double blind, placebo controlled, double crossover study. It compared pycnogenol, methylphenidate, and
placebo. Placebo was most effective in
controlling ADHD symptoms, suggesting that either pycnogenol is ineffective or
that the dosing was not right.
A 2012
Cochrane review of the subject (which involved all studies available today
on the topic of ADHD and pycnogenol) concluded that the evidence that
pycnogenol is helpful for ADHD is still lacking and that bigger studies need to
be done to produce convincing statistics.
Side effects
One might argue that if pycnogenol is potentially effective,
at least it will do no harm to try it.
Unfortunately, this is a potentially dangerous line of reasoning. So far, in small trials run for short periods
of time (usually less than 12 weeks), pycnogenol has been fairly well tolerated
with no shocking side effects reported.
However, pycnogenol is an antioxidant, and we know that the body uses
oxidative products as part of the immune response. It is possible that pycnogenol may cause long
term problems such as autoimmune disease, cancer, or immune deficiencies. One need only look to the example of vitamin
E and lung cancer to understand how important it is to run clinical trials to
pick up on side effects such as these.
Additionally, pycnogenol has been shown in some clinical trials to
possibly inhibit blood clotting, which raises the question as to whether it
could also cause unwanted bleeding.
Overall, we just don't know what the side effects of
pycnogenol are, though potentially it could have some significant ones.
Who should try
pycnogenol for their ADHD? This
supplement is promising in its effectiveness, but no more than promising, and
it does have the potential to have some serious side effects in the long
term. Until it is clear that the
benefits outweigh the risks, most patients with ADHD should skip this
supplement. However, patients who have
tried multiple medications and other proven nondrug therapies, and who still
have significant symptoms may consider trying this as a last resort over
therapies which have little efficacy and proven severe side effects, such as
marijuana.
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