Are There Any Alternative Treatments for Epilepsy?

There have been some studies of alternative treatments for epilepsy -- including biofeedback, melatonin, or large doses of vitamins. Here is what they found:

Biofeedback

Biofeedback is a method of using relaxation or imagery to change body functions such as breathing, heart rate and blood pressure. A biofeedback practitioner measures these functions with electrodes and a monitor. The practitioner describes a stressful situation and then teaches the patient various relaxation techniques.

The patient can see on the monitor the differences between stressed and relaxed situations. He or she can then use the relaxation techniques to feel more relaxed and control these body functions.

Biofeedback has been shown to help people with high blood pressure, migraine headaches and pain. Researchers have investigated whether biofeedback can help control seizures, but the results have not been encouraging. However, patients who have seizures triggered by anxiety or stressful situations may benefit from this therapy, in addition to their seizure medications.

Melatonin

Melatonin is a hormone that is manufactured by the pineal gland in the brain. Melatonin has been touted as an anti-aging substance, as a sleep aid, and as an antioxidant (a substance that protects against free radicals -- molecules that can damage the body). Studies into these claims have not been conclusive.

As for epilepsy, one study showed that melatonin may reduce the incidence of seizures in children, while another study found that melatonin increased the risk of seizures. At this time, it is believed that melatonin does not significantly help prevent seizures.

Vitamins

Although vitamins are necessary for good health, large doses of vitamins do not improve the symptoms of epilepsy and may even be harmful. You should get most of your vitamins from food by eating abalanced diet. If necessary, vitamin supplements such as folic acidcan help deal with vitamin loss caused by medication. People with epilepsy taking seizure medications do appear to have an increased need for calcium and vitamin D to help keep their bones healthy.Pregnant women also need sufficient folic acid to help prevent birth defects.

Reviewed by The Cleveland Clinic Neuroscience Center.

Electroencephalogram (EEG)

An electroencephalogram (EEG) is a test that measures and records the electrical activity of your brain. Special sensors (electrodes) are attached to your head and hooked by wires to a computer. The computer records your brain's electrical activity on the screen or on paper as wavy lines. Certain conditions, such as seizures, can be seen by the changes in the normal pattern of the brain's electrical activity.

Why It Is Done

An electroencephalogram (EEG) may be done to:

• Diagnose epilepsy and see what type of seizures are occurring. EEG is the most useful and important test in confirming a diagnosis of epilepsy.
• Check for problems with loss of consciousness or dementia.
• Help find out a person's chance of recovery after a change in consciousness.
• Find out if a person who is in a coma is brain-dead.
• Study sleep disorders, such as narcolepsy.
• Watch brain activity while a person is receiving general anesthesia during brain surgery.
• Help find out if a person has a physical problem (problems in the brain, spinal cord, or nervous system) or a mental health problem.

How To Prepare

Before the day of the electroencephalogram (EEG) test, tell your doctor if you are taking any medicines. Your doctor may ask you to stop taking certain medicines (such as sedatives and tranquilizers, muscle relaxants, sleeping aids, or medicines used to treat seizures) before the test. These medicines can affect your brain's usual electrical activity and cause abnormal test results.

Do not eat or drink foods that have caffeine (such as coffee, tea, cola, and chocolate) for 8 hours before the test.

Since the electrodes are attached to your scalp, it is important that your hair be clean and free of sprays, oils, creams, and lotions. Shampoo your hair and rinse with clear water the evening before or the morning of the test. Do not put any hair conditioner or oil on after shampooing.

To find certain types of abnormal electrical activity in the brain, you may have to be asleep during the recording. You may be asked not to sleep at all the night before the test or to sleep less (about 4 or 5 hours) by going to bed later and getting up earlier than usual. If your child is going to be tested, try to keep him or her from taking naps just before the test. If you know that you are going to have a sleep-deprived EEG, plan to have someone drive you to and from the test.

How It Is Done

An electroencephalogram (EEG) may be done in a hospital or in a doctor's office by an EEG technologist. The EEG record is read by a doctor who is specially trained to diagnose and treat disorders affecting the nervous system (neurologist).

You will be asked to lie on your back on a bed or table or relax in a chair with your eyes closed. The EEG technologist will attach 16 to 25 flat metal discs (electrodes) to different places on your head, using a sticky paste to hold the electrodes in place. A cap with fixed electrodes may be placed on your head instead of individual electrodes. In rare cases, these electrodes may be attached to the scalp with tiny needles.

The electrodes are hooked by wires to a computer that records the electrical activity inside the brain. A machine can show the activity as a series of wavy lines drawn by a row of pens on a moving piece of paper or as an image on the computer screen.

Lie still with your eyes closed during the recording, and do not talk to the technologist unless you need to. The technologist will watch you directly or through a window during the test. The recording may be stopped from time to time to allow you to stretch and reposition yourself.

The technologist may ask you to do different things during the test to record what activity your brain does at that time.

• You may be asked to breathe deeply and rapidly (hyperventilate). Usually you will take 20 breaths a minute for 3 minutes.
• You may be asked to look at a bright, flashing light called a strobe. This is called photic or stroboscopic stimulation.
• You may be asked to go to sleep. If you cannot fall asleep, you may be given a sedative to help you fall asleep. If an EEG is being done to check a sleep problem, an all-night recording of your brain's electrical activity may be done.

An EEG takes 1 to 2 hours. After the test, you may do your normal activities. But if you were sleep-deprived or given a sleep medicine, have someone drive you home after the test.

How It Feels

There is no pain with an electroencephalogram (EEG).

If paste is used to hold the electrodes, some paste may stay in your hair after the test, so you will have to wash your hair to remove it. If needle electrodes are used (which is rare), you will feel a brief, sharp prick (about like having a hair pulled out) when each electrode is inserted. If electrodes are placed in your nose, they may cause a tickling feeling and, rarely, some soreness or a small amount of bleeding for 1 to 2 days after the test.

If you are asked to breathe rapidly, you may feel lightheaded or have some numbness in your fingers. This reaction is normal. It will go away a few minutes after you start breathing normally again.

Risks

An electroencephalogram (EEG) is a very safe test. The electrical activity of your brain is recorded, but at no time is any electrical current put into your body. An EEG should not be confused with electroshock (electroconvulsive) therapy.

If you have a seizure disorder such as epilepsy, a seizure may be triggered by the flashing lights or by hyperventilation. If this occurs, the technologist is trained to take care of you during the seizure.

Results

An electroencephalogram (EEG) is a test that measures and records the electrical activity of your brain. Special sensors (electrodes) are attached to your head and hooked by wires to a computer. EEG test results are ready on the same or the next day.

There are several types of brain waves:

• Alpha waves have a frequency of 8 to 12 cycles per second. Alpha waves are present only in the waking state when your eyes are closed but you are mentally alert. Alpha waves go away when your eyes are open or you are concentrating.
• Beta waves have a frequency of 13 to 30 cycles per second. These waves are normally found when you are alert or have taken high doses of certain medicines, such as benzodiazepines.
• Delta waves have a frequency of less than 3 cycles per second. These waves are normally found only when you are asleep or in young children.
• Theta waves have a frequency of 4 to 7 cycles per second. These waves are normally found only when you are asleep or in young children.

Electroencephalogram (EEG)

Normal:	In adults who are awake, the EEG shows mostly alpha waves and beta waves.
	The two sides of the brain show similar patterns of electrical activity.
	There are no abnormal bursts of electrical activity and no slow brain waves on the EEG tracing.
	If flashing lights (photic stimulation) are used during the test, one area of the brain (the occipital region) may have a brief response after each flash of light, but the brain waves are normal.
Abnormal:	The two sides of the brain show different patterns of electrical activity. This may mean a problem in one area or side of the brain is present.
	The EEG shows sudden bursts of electrical activity (spikes) or sudden slowing of brain waves in the brain. These changes may be caused by a brain tumor, infection, injury, stroke, or epilepsy. When a person has epilepsy, the location and exact pattern of the abnormal brain waves may help show what type of epilepsy or seizures the person has. Keep in mind that in many people with epilepsy, the EEG may appear completely normal between seizures. An EEG by itself may not diagnose or rule out epilepsy or a seizure problem.
	The EEG records changes in the brain waves that may not be in just one area of the brain. A problem affecting the entire brain-such as drug intoxication, infections (encephalitis), or metabolic disorders (such as diabetic ketoacidosis) that change the chemical balance in the body, including the brain-may cause these kinds of changes.
	The EEG shows delta waves or too many theta waves in adults who are awake. These results may mean brain injury or a brain illness is present. Some medicines can also cause this.
	The EEG shows no electrical activity in the brain (a "flat" or "straight-line" EEG). This means that brain function has stopped, which is usually caused by lack of oxygen or blood flow inside the brain. This may happen when a person has been in a coma. In some cases, severe drug-induced sedation can cause a flat EEG.

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

• Moving too much.
• Taking some medicines, such as those used to treat seizures (antiepileptic medicines) or sedatives, tranquilizers, and barbiturates.
• Being unconscious from severe drug poisoning or a very low body temperature (hypothermia).
• Having hair that is dirty, oily, or covered with hairspray or other hair preparations. This can cause a problem with the placement of the electrodes.

What To Think About

• If the doctor thinks that a person has epilepsy but the EEG is normal, the technologist running the EEG test may have the person look at a flashing light (photic stimulation), breathe fast and deeply (hyperventilation), or sleep during the test. These techniques sometimes show epileptic EEG patterns that did not show up at first. If epilepsy is suspected after an initial EEG, the doctor may repeat the EEG more than once.
• An EEG done during a seizure will almost always show abnormal electrical patterns. This makes an EEG useful when a doctor thinks that a person is having psychogenic seizures (pseudoseizures), which have no physical cause but can be caused by stress, emotional trauma, or mental illness. Psychogenic seizures do not cause abnormal electrical activity in the brain and will not show abnormal EEG results.
• Other tests that may also be done include:
  • Video EEG. Video EEG records seizures on videotape and on computer so that the doctor can see what happens just before, during, and right after a seizure. This test can be very helpful in finding the specific area of the brain that the seizures may be coming from. It is also helpful in diagnosing psychogenic seizures, which may look like real seizures but do not affect the electrical activity in the brain. Video EEG may be used short-term or long-term:
    • Short-term monitoring is done on an outpatient basis and may last up to 6 hours.
    • Long-term monitoring is done in the hospital and may last 3 to 7 days.
  • Brain mapping. Brain mapping is a fairly new method that is very similar to EEG. With electrodes placed on the person's scalp to transmit the brain's electrical activity, a computer makes a color-coded map of signals from the brain. It is sometimes done to find a specific problem area in the brain that has already shown up on a regular EEG. Doctors are still not certain how brain mapping could be best used.
  • Ambulatory EEG monitoring. In ambulatory EEG monitoring, the person is able to move around, and the test allows for long periods of time in recording of electrical activity in the brain. Fewer electrodes are attached to the person, and the person carries a small, portable recording unit. The recording may last for a full day or more, and the person is allowed to leave the hospital. Ambulatory EEG monitoring is not as accurate as a regular EEG.

  Other Works Consulted

  • Chernecky CC, Berger BJ, eds. (2004). Laboratory Tests and Diagnostic Procedures, 4th ed. Philadelphia: Saunders.

  • Fischbach FT, Dunning MB III, eds. (2004). Manual of Laboratory and Diagnostic Tests, 7th ed. Philadelphia: Lippincott Williams and Wilkins.

  • Pagana KD, Pagana TJ (2006). Mosby’s Manual of Diagnostic and Laboratory Tests, 3rd ed. St. Louis: Mosby.

Epilepsy Guide -Seizure Types and Symptoms

Based on the type of behavior and brain activity, seizures are divided into two broad categories: generalized and partial (also called local or focal). Classifying the type of seizure helps physicians diagnose whether or not a patient has epilepsy.

Generalized seizures are produced by electrical impulses from throughout the entire brain, whereas partial seizures are produced (at least initially) by electrical impulses in a relatively small part of the brain. The part of the brain generating the seizures is sometimes called the focus. The most common types of seizures are listed below:

Generalized Seizures (Produced by the entire brain)	Symptoms
1. "Grand Mal" or Generalized tonic-clonic	Unconsciousness, convulsions, muscle rigidity
2. Absence	Brief loss of consciousness
3. Myoclonic	Sporadic (isolated), jerking movements
4. Clonic	Repetitive, jerking movements
5. Tonic	Muscle stiffness, rigidity
6. Atonic	Loss of muscle tone

Generalized Seizures

There are six types of generalized seizures. The most common and dramatic, and therefore the most well known, is the generalized convulsion, also called thegrand-mal seizure. In this type of seizure, the patient loses consciousness and usually collapses. The loss of consciousness is followed by generalized body stiffening (called the "tonic" phase of the seizure) for 30 to 60 seconds, then by violent jerking (the "clonic" phase) for 30 to 60 seconds, after which the patient goes into a deep sleep (the "postictal" or after-seizure phase). During grand-mal seizures, injuries and accidents may occur, such as tongue biting and urinary incontinence.

Absence seizures cause a short loss of consciousness (just a few seconds) with few or no symptoms. The patient, most often a child, typically interrupts an activity and stares blankly. These seizures begin and end abruptly and may occur several times a day. Patients are usually not aware that they are having a seizure, except that they may be aware of "losing time."

Myoclonic seizures consist of sporadic jerks, usually on both sides of the body. Patients sometimes describe the jerks as brief electrical shocks. When violent, these seizures may result in dropping or involuntarily throwing objects.

Clonic seizures are repetitive, rhythmic jerks that involve both sides of the body at the same time.

Tonic seizures are characterized by stiffening of the muscles.

Atonic seizures consist of a sudden and general loss of muscle tone, particularly in the arms and legs, which often results in a fall.

Partial Seizures (Produced by a small area of the brain)	Symptoms
1. Simple(awareness is retained) a. Simple Motor b. Simple Sensory c. Simple Psychological	a. Jerking, muscle rigidity, spasms, head-turning b. Unusual sensations affecting either the vision, hearing, smell taste or touch c. Memory or emotional disturbances
2. Complex (Impairment of awareness)	Automatisms such as lip smacking, chewing, fidgeting, walking and other repetitive, involuntary but coordinated movements
3. Partial seizure with secondary generalization	Symptoms that are initially associated with a preservation of consciousness that then evolves into a loss of consciousness and convulsions.

Partial Seizures

Partial seizures are divided into simple, complex and those that evolve into secondary generalized seizures. The difference between simple and complex seizures is that during simple partial seizures, patients retain awareness; during complex partial seizures, they lose awareness.

Simple partial seizures are further subdivided into four categories according to the nature of their symptoms: motor, autonomic, sensory or psychological. Motor symptoms include movements such as jerking and stiffening. Sensory symptoms caused by seizures involve unusual sensations affecting any of the five senses (vision, hearing, smell, taste or touch). When simple partial seizures cause sensory symptoms only (and not motor symptoms), they are called "auras."

Autonomic symptoms affect the autonomic nervous system, which is the group of nerves that control the functions of our organs, like the heart, stomach, bladder, intestines. Therefore autonomic symptoms are things like racing heart beat, stomach upset, diarrhea, loss of bladder control. The only common autonomic symptom is a peculiar sensation in the stomach that is experienced by some patients with a type of epilepsy called temporal lobe epilepsy. Simple partial seizures with psychological symptoms are characterized by various experiences involving memory (the sensation of deja-vu), emotions (such as fear or pleasure), or other complex psychological phenomena.

Complex partial seizures, by definition, include impairment of awareness. Patients seem to be "out of touch," "out of it" or "staring into space" during these seizures. There may also be some "complex" symptoms called automatisms. Automatisms consist of involuntary but coordinated movements that tend to be purposeless and repetitive. Common automatisms include lip smacking, chewing, fidgeting and walking.

The third kind of partial seizure is one that begins as a focal seizure and evolves into a generalized convulsive ("grand-mal") seizure. Most patients with partial seizures have simple partial, complex partial and secondarily generalized seizures. In about two-thirds of patients with partial epilepsy, seizures can be controlled with medications. Partial seizures that cannot be treated with medications can often be treated surgically.

Epilepsy and Your Changing Hormones

Women with epilepsy face different issues than do men with epilepsy. For some women, the pattern of epileptic seizures is directly affected by the normal hormonal cycles they experience throughout their lives.

Two primary sex hormones flow through women's bodies. One is estrogen and the other is progesterone. Most of the time, your body has about the same amount of each.

What does that have to do with epilepsy? Doctors have learned that both of these hormones interact with brain cells. Estrogen is an "excitatory" hormone, which means that it makes brain cells give off more of an electrical discharge. Progesterone, on the other hand, is an "inhibitory" hormone, which means that it calms those cells down.

When the body is making more estrogen than progesterone, it can make the nervous system "excitable." In other words, you could be at greater risk for seizures. The hormones aren't actually causing the seizures, but they can influence when they happen.

Some women with epilepsy have more seizures at times when their hormones are changing. For example, some young women have their first seizures at puberty. Other women have more seizures around the time of their menstrual periods. This doesn't happen to all women, so doctors are still learning about how hormones and epilepsy interact.

Epilepsy and Your Menstrual Period

Some women have a form of epilepsy called catamenial epilepsy. This refers to seizures that are affected by a woman's menstrual cycle. Doctors aren't completely sure how many women with epilepsy have this, but they think it's about 10% to 12%.

The exact cause of these seizures is unknown. However, some women have most of their seizures when there is a lot of estrogen in their body, such as during ovulation. Other women have seizures when progesterone levels tend to drop, such as right before or during their period.

If you have seizures that start around the last half of your menstrual cycle and continue through the whole second half of your cycle, then you might have another type of catamenial epilepsy. This is when a woman has menstrual cycles that do not release an egg. These are called "anovulatory" cycles.

Women with epilepsy have more anovulatory cycles than other women do. Some doctors think that as many as 40% of menstrual cycles in women with epilepsy do not release an egg. It depends on the woman, and it is not always the same every month. Some months a woman will release an egg, and some months she will not. In general, though, women with epilepsy do not ovulate as regularly as women without epilepsy.

Why is that? Doctors do not know for certain. But, some seizures start in the temporal lobes of the brain. This is an area that is very closely connected to the areas regulating hormones. Women who have seizures that start in the temporal lobes may have their hormone production affected by their seizures.

If you can identify the role hormones play in your seizure patterns, it can help with your treatment. Try keeping a calendar of your menstrual cycle, and the days that you have seizures. Include notes about other factors that might be important, such as missed medication, sleep loss, stress, or illness. By sharing these records with your doctor, you can work together to manage your epilepsy more effectively.

Epilepsy and Life Changes

As you've already learned, many people develop their first seizures when they enter puberty. This happens to both men and women. Doctors think this is because before puberty we don't have many sex hormones circulating in our body. After puberty there are many more hormones in the body. And as you've seen, hormones do have a direct effect on the cells of the brain.

Does that mean that a woman's seizures might go away when she reaches menopause? Sometimes, but not always. In some women, seizures do seem to just disappear. This usually happens in women who have catamenial epilepsy. For other women, menopause doesn't seem to make a difference in their seizures. And still other women have worse seizures during menopause.

Most of the time, though, doctors say that seizures become easier to control as you get older. They are not sure if that's because the seizures themselves are decreasing, or because newer medications are now available that control epilepsy better than in the past.

Keep in mind that some types of antiseizure medications can cause bone loss when taken over a long period of time. Since osteoporosis is a particular problem for women who have reached menopause, this would be a good time to talk with your doctor about your medication and what you can do to help prevent osteoporosis. On the whole, it's best to build strong bones early in life - in your 20s and 30s - and not wait till you're close to menopause when some of your bone strength may have already been lost

ADHD Medications Help Kids in School

April 27, 2009 -- Kids with ADHD usually struggle in the classroom, but new research offers support that medication can help them achieve in school.

In the study, grade school-aged children with attention deficit hyperactivity disorder (ADHD) who took medication performed better on standardized math and reading tests than children with ADHD who did not take medication.

More than 4 million children in the United States have a diagnosis of ADHD, and it is believed that about 60% take prescription medications, mostly stimulant drugs like Ritalin, Concerta, and Adderall, for the disorder.

“Our study shows that there is a true, long-term learning effect that can be measured objectively,” lead researcher Richard Scheffler, PhD, of the University of California, Berkeley School of Public Health, tells WebMD.

ADHD Treatment and Learning

The study included nearly 600 children with ADHD from across the U.S. followed from kindergarten through fifth grade.

Researchers were able to track the children’s academic progress by examining standardized math and reading scores. They also had information about each child’s family and medical background.

Medicated children were about one-fifth of a school year ahead of their non-medicated peers in math and about one-third of a school year ahead in reading, but both groups still lagged behind their classmates who did not have ADHD.

Although earlier studies have shown that medication helps with short-term memory in the classroom, the study is one of the first to show that treatment is associated with long-term improvements in academic performance, Scheffler says.

The research, funded by the National Institute of Mental Health, appears in the May issue of the journal Pediatrics.

“We are not saying that all children with ADHD need to be on medication,” Scheffler says. “Drugs are not the answer by themselves. But it is clear that many minority and low-income children have less access to drug treatments.”

Improving this access, Scheffler says, could lead to better academic performance for the most vulnerable children with ADHD.

Many Kids With ADHD Have Other Issues

As the mother of two children with ADHD, Trish White has seen firsthand the difference medication can make in the classroom.

But she stresses that drug treatment is just one of many interventions that can make a difference in the academic performance of kids with ADHD.

White’s son, who is now 12, was diagnosed with ADHD in the second grade; her daughter, now 8, was diagnosed in first grade.

Both children take medication for the disorder, and both have shown improvements in the classroom.

“The drugs help, but they are not a cure-all,” she says. “Drugs are just one part of it.”

School-based interventions like seating children with ADHD closer to the teacher to keep their attention focused and giving them more time to complete assignments are also important, she says.

ADHD researcher Lily Hechtman, MD, of McGill University, says that although ADHD drugs can help children, many children with ADHD have learning issues that the drugs do not address.

“About 20% of children with attention deficit disorders also have very specific learning disabilities,” she says. “These children clearly need other interventions.”

Even children without specific learning disabilities who have fallen behind academically will need more than medication to catch up if they are diagnosed after years of struggle in the classroom, she says.

Diagnosing ADHD in Children

When you take your child to the pediatrician for a sore throat, a quick test can tell if it’s strep throat and put your child on the way to a course of antibiotics and generally a quick recovery. But when it comes to diagnosing attention deficit hyperactivity disorder (ADHD) – a condition in which children display symptoms of hyperactivity and impulsiveness, or inattention, or a combination of these -- the diagnostic process is rarely quick or easy. In fact, in many cases, the pediatrician is not the one to make the diagnosis.

Although some pediatricians with special training in the disorder will diagnose ADHD in children, most will refer you and your child to a mental health professional such as a psychologist, psychiatrist, counselor, or social worker trained in diagnosing and treating the disorder through behavioral management. You can also find a professional who specializes in ADHD diagnosis through your health plan, your child’s teacher or school counselor, other parents of children with ADHD, or nonprofit organizations such as Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).

Criteria for ADHD Diagnosis

The person who evaluates your child for ADHD will be looking for the presence and severity of specific behaviors. The behaviors vary, depending on which of the three types of ADHD a child appears to have: hyperactivity-impulsivity, inattention, or combination. Different types of ADHD include these different symptoms in children:

Hyperactivity

• Often fidgets with hands or feet, or squirms in seat
• Often gets up from seat
• Often has trouble enjoying quiet activities
• Often runs or climbs where not appropriate
• Often talks excessively

Impulsivity

• Often blurts out answer before questions have been finished
• Often has trouble waiting his or her turn
• Often interrupts others

Inattention

• Often makes careless mistakes in schoolwork or other activities
• Often has trouble focusing on tasks or activities
• Often does not seem to listen when spoken to directly
• Often has trouble organizing activities
• Often does not follow instructions
• Often loses things needed for tasks or activities

Although many children display some of the behaviors for ADHD, they do not necessarily have the disorder. An ADHD diagnosis requires that these behaviors have been persistent for at least six months, that some symptoms began before age seven, that symptoms are present in two or more settings (such as school and home), and that they cause significant impairment in social or school functioning.

ADHD in Children: How a Diagnosis Is Made

The first step toward diagnosing ADHD should be a full physical exam. Then the psychologist or other mental health professional who evaluates your child for ADHD will probably set up an interview with you and two or more sessions with your child before making a diagnosis.

The evaluator will rule out other causes of your child’s behavior such as:

• A sudden life change (such as divorce, a death in the family, or moving)
• Undetected seizures
• Thyroid problems
• Lead toxicity
• Sleep problems
• Hearing problems
• Learning disability
• Anxiety
• Depression

To do this, he will check your child’s medical and school records, and perhaps question both of you about what else is going on in your child's life. He may also administer tests to determine if your child has a learning disorder or some other problem that may be causing the behaviors.

If possible, the person making the diagnosis will want to observe your child’s behavior in the classroom and interview you and her teachers – and perhaps other adults who interact with your child on a regular basis – about your child's behaviors. The evaluator may also ask each of you to complete standardized forms, known as “behavior rating scales,” to rate different aspects of your child’s behavior.

Diagnosing ADHD in Adults

For an estimated 60% of children with ADHD, symptoms persist into adulthood. And, some adults with symptoms of ADHD were never diagnosed with the condition as children.

Sometimes an adult will recognize the symptoms in himself when his son or daughter is diagnosed. Other times, an adult who has sought help from a psychologist or counselor for depression, anxiety, or other problems discovers that they are related to ADHD.

Symptoms of ADHD in adults can include:

• Chronic lateness and forgetfulness
• Anxiety
• Lack of organizational skills
• Low self-esteem
• Employment problems
• Difficulty controlling anger
• Impulsiveness

Symptoms of ADHD must have been present in childhood. For adults, these behaviors can cause problems at home, work, or school if not managed appropriately. If you suspect that you may have ADHD, talk to your doctor or therapist about how to proceed with an evaluation.

Vitamins and Supplements for ADHD

Have you ever wondered whether vitamins and supplements can help treat the symptoms of ADHD?

Over the past few decades, alternative and complementary medicine has gained in popularity. As a result, there is now a wide range of nontraditional approaches to personal health and healing. These various remedies are sometimes used in the place of standard medical approaches. Oftentimes, though, they are used in addition to standard medical therapy. Some alternative remedies are safe, relatively affordable, and easily accessible. And some may actually create an opportunity for you to participate actively in key decisions about your health.

On the other hand, there are other natural or alternative remedies that are unsafe. That's why it's important to know what works -- and what doesn't -- when it comes to nonstandard treatments for conditions like ADHD. The fact that claims are made that a vitamin or supplement is natural is not a guarantee that it's safe. It's important to always discuss any therapy with your doctor before taking it.

Read on to discover whether there are vitamins and natural supplements that are safe and effective for treating symptoms of ADHD.

Zinc for ADHD symptoms

Some studies suggest that children with ADHD may have lower levels of zinc in their body. And some scientists have reported improved symptoms in children with ADHD who took zinc supplements along with traditional ADHD treatment.

Several studies have shown a reduction in hyperactivity and impulsivity with zinc supplementation. The same studies, though, report no change in inattentiveness, which is another key symptom of ADHD. A 2005 study in the Journal of Child and Adolescent Psychopharmacology, though,did show a correlation between zinc levels and teacher- and parent-rated inattention in children.

Foods high in zinc include oysters and other seafood, red meat, poultry, dairy products, beans, nuts, whole grains, and fortified cereals.

Fish oil for ADHD symptoms

There is some evidence that fish oil can help improve ADHD symptoms. Fish oil contains omega-3 fatty acids. There are some findings that suggest that, in children with ADHD who are 8 to 12 years old, fish oil supplementation may improve mental skills. For instance, it may help improve a child's ability to organize activities.

In one study, a specific supplement of fish oil and evening primrose oil was used. Results showed that it improved hyperactivity, inattentiveness, an inability to think clearly, and overall behavior in children with ADHD who were 7 to 12 years old.

Fish high in omega 3 fatty acids include salmon, albacore tuna, herring, mackerel, trout, and sardines.

St. John's wort: No help for ADHD

St. John's wort is a common herbal supplement. It's used for treating depression,anxiety, and sleep disorders. This herbal treatment affects brain chemicals, including serotonin, dopamine, and norepinephrine.

Recent scientific studies do not support the use of St. John's wort to treat ADHD. In fact, recent findings conclude that St. John's wort has no effect on the symptoms of ADHD.

One study involved a group of children and adolescents with ADHD ranging in age from 6 to17. Each child and adolescent was given either a placebo or St. John's wort supplement three times a day for 8 weeks. They were then evaluated for changes in their hyperactivity and inattentiveness. The results showed no difference between the two groups.

Other natural supplements for ADHD

There is some preliminary evidence that some natural supplements may benefit people with ADHD. For example, in one study, a combination of American ginseng and Ginkgo leaf improved ADHD symptoms in children ages 3 to 17. But researchers conclude that more scientific studies are needed to confirm this finding.

Some research also shows that the natural hormone melatonin may offer some benefit for children with ADHD who take stimulant medications. Researchers noted that it improved sleep problems in these children. Melatonin, though, has not been found effective in decreasing ADHD symptoms.

Natural supplements such as GABA and inositol are sometimes used to treat ADHD and ease mood symptoms. Neither one of these natural products is proven to be effective, though. Also, there is still insufficient evidence about the safety of either product.

Can nutritional supplements help with ADHD by filling dietary gaps?

Some proponents of nutritional supplements believe that ADHD symptoms occur because of a lack in the diet. They also believe that supplements are needed to fill that dietary gap.

For instance, there are some studies on using iron supplements to treat ADHD. Findings from these studies suggest that children with ADHD may have iron deficiencies. The hypothesis is that supplementing with iron may improve ADHD symptoms.

It's important, though, to use caution when giving your child any supplement. Taking too much iron, for instance, can be toxic -- even deadly. It's important to check with your child's doctor if you believe your child may be iron deficient.

In addition, always talk to your doctor before using any natural supplements. That includes megadoses of vitamins or minerals. That's because there's always a chance of toxicity or of interaction with medication.

ADHD Drugs: Sudden Death Risk Higher?

June 15, 2009 -- A new study suggests that children and teens who take stimulants like Ritalin for ADHD have an increased risk for sudden cardiac death, but the FDA says the study has major limitations and should not change the way the drugs are used.

There have long been concerns that the stimulants used to treat ADHD may increase the risk for sudden death in children with undiagnosed heart conditions.

The new research finds corroborating evidence for concern, although all agree that the risk of sudden cardiac death is very small.

ADHD Stimulants and Sudden Cardiac Death

Researchers collected data on stimulant use among 564 children and teenagers who died unexpectedly of unknown causes and an equal number who died as passengers in auto accidents. Many of the unexplained deaths were later attributed to previously undiagnosed cardiac arrhythmias.

They concluded that the odds of using stimulant medication were six to seven times greater among the children who died suddenly of unexplained causes than among those who died in car crashes.

Ten children who died of unknown causes (just under 2%) took stimulants, compared to two children (0.4%) who died in auto accidents.

The study does not prove that ADHD drugs cause cardiac deaths. But lead researcher Madelyn S. Gould, PhD, tells WebMD that the results highlight the importance of carefully screening children and teens for heart conditions when the medications are prescribed.

The research was published today online and will appear in The American Journal of Psychiatry.

“These are very rare events, and parents should not be overly concerned,” she says. “This shouldn’t stop anyone from using medications that can help children. But the clinicians who prescribe these drugs must be vigilant about screening and monitoring their patients.”

FDA: Study Doesn’t Prove Link

The FDA and the National Institute of Mental Health funded the study, but FDA officials expressed reservations about the findings in a written statement and news briefing held today.

“Given the limitations of this study’s methodology, the FDA is unable to conclude that these data affect the overall risk-and-benefit profile of stimulant medications used to treat ADHD in children.”

The biggest limitation, FDA officials said, is that information on stimulant use was collected years and in some cases a decade or more after the children died.

They expressed concern that recalling their children's stimulant use many years later might be greater for parents and physicians of children who died suddenly of unexplained causes.

Robert Temple, MD, of the FDA, said an ongoing study of cardiac outcomes among children taking stimulants for ADHD should provide additional information about risk.

Results from this study, also funded by the FDA and the Agency for Healthcare Research and Quality (AHRQ), should be published in a few months, he said.

ADHD Drugs Have Warnings

It is estimated that more than 2.5 million children and teens in the United States take stimulants to control their ADHD.

Drugs like Ritalin, Adderall, Dexedrine, and Concerta are known to increase heart rates and raise blood pressure, but the risk has not been considered significant in otherwise healthy children.

The FDA requires that these drugs include labeling warning of the risk of sudden cardiac death in patients with heart problems, but the incidence of cardiac events among children and teens taking the drugs for ADHD is not known.

In March of 2006, an FDA panel reported that between 1992 and 2005, 11 sudden cardiac deaths occurred in children taking Ritalin and Concerta, which both contain the stimulant methylphenidate, and 13 sudden cardiac deaths occurred among children taking the amphetamine-containing stimulants Adderall and Dexedrine. Three sudden cardiac deaths were also reported among children taking the ADHD drug Strattera, which is not a stimulant.

Late last year, a special panel of the American Heart Association recommended screening all children and teens taking ADHD drugs for hidden heart problems. The panel also called for electrocardiogram (ECG) screening of all patients being placed on the stimulants for the first time.

Editorial: ‘Drugs Aren’t Innocuous’

In an editorial published with the study, Benedetto Vitiello, MD, and Kenneth Towbin, MD, of the National Institute of Mental Health, write that this report “should underscore that stimulants are not innocuous and that their therapeutic use requires careful diagnostic assessment, diligent safety screening, and ongoing monitoring.”

Ritalin, Concerta, and other ADHD drugs are increasingly being used recreationally, usually in an effort to boost academic or job performance.

Vitiello tells WebMD that recreational users mistakenly think of these drugs as safe.

“These drugs are being widely misused, and people need to know that they are not benign,” he says.

A spokeswoman for McNeil Pediatrics, which makes Concerta, told WebMD that the company “welcomes any data that adds to the body of knowledge in this therapeutic area.”

Calls to Shire Pharmaceuticals, which manufactures Adderall, and Novartis Pharmaceuticals, which markets Ritalin LA, were not returned in time for publication.