Tocotrienol-rich fractions (TRF) supplementation in school-going children with Attention Deficit/Hyperactive Disorder (ADHD): A randomized controlled trial

Abstract

Background: Attention Deficit/Hyperactive Disorder (ADHD) is often treated with medications but many parents seek alternative treatment for fear of adverse effects. Increased oxidative stress has been observed in children and adults with ADHD. We postulate that tocotrienol-rich fractions (TRF), a potent antioxidant from the natural Vitamin E family, may help children with ADHD. The objective of this study is to determine if supplementation of TRF has an effect on the symptoms of school-going children with ADHD. Methods: Children aged between 6 to 12 years with ADHD were randomized to TRF 200 mg or placebo daily for 6 months. We measured the NICHQ Vanderbilt ADHD Parent (VAPRS) & Teacher (VATRS) Rating Scales at baseline, 3 months and 6 months. Plasma tocotrienol levels were also measured at each of the corresponding time. We used ANOVA repeated measure and Spearman Rho's for analysis. Results: One hundred forty-six children were randomized. The VAPRS showed significant improvement after 3 months and 6 months in both groups (n = 73 each). The VATRS revealed greater improvement in the TRF group but was not statistically significant (p = 0.07). The TRF group had higher levels of tocotrienols compared with the placebo group at 3 and 6 months. There was a small but significant correlation of the alpha and gamma tocotrienol levels with the change in VAPRS after 6 months. Conclusion: TRF was not more effective than placebo in reducing the ADHD symptoms as measured by the VAPRS and VATRS. Possible reasons for this include placebo-effects and supplementations given too late in life. Future studies should consider using an objective outcome measurement (e.g. measuring attention-span) as well as earlier age of supplementation. Trial registration: ClinicalTrials.gov NCT01855984, date of registration 10 May 2013.