One study involving 61 participants with ADHD was included in the review. A 2020 Cochrane systematic review assessed the efficacy and safety of pine bark extract for various chronic disorders, including ADHD.There is insufficient evidence on the efficacy and safety of Pycnogenol for the treatment of ADHD. There have been no reports of significant side effects of melatonin in children. Side effects of melatonin are uncommon but can include drowsiness, headache, dizziness, or nausea.Melatonin appears to be safe when used short-term, but there is lack of long-term studies.The effects of melatonin on behavior and daytime functioning, however, weren’t clear because the studies used different ways to measure these outcomes. The studies involving children with ADHD found that children with ADHD who took melatonin fell asleep 20 minutes earlier and slept 33 minutes longer. A 2019 review of 19 studies involving a total of 1,021 children found that, overall, melatonin was better than placebo for improving both the time to fall asleep and total sleep.A 2020 review concluded that melatonin supplementation improves sleep delay as well as extends overall sleep duration in people with ADHD.However, there is insufficient data to make conclusions about the safety and effectiveness of long-term melatonin use, although one 2009 study evaluated the efficacy and safety of long-term (mean time up to 3.7 years) treatment of melatonin for children with ADHD and insomnia, and no serious adverse events were reported. One recent review found that melatonin supplementation improves sleep delay as well as extends overall sleep duration in people with ADHD. There is limited evidence from rigorous clinical trials on melatonin for sleep disorders among young people with ADHD. When side effects do occur, they typically consist of minor gastrointestinal symptoms. Omega-3 fatty acid supplements usually do not have negative side effects.Further, another 2017 systematic review with network meta-analyses of 190 randomized trials found that there is a lack of evidence for complementary health approaches, including fatty acids, for the treatment of ADHD in children and adolescents. Of the studies included in the review, there were variations in sample size, study duration, type, and dosage of supplementation, making it difficult to compare the findings and draw firm conclusions about the efficacy. However, a 2017 systematic review of 25 randomized controlled trials found about half of the studies reporting some beneficial effect of omega-3 fatty acids on ADHD symptoms, and half reporting negative results. A 2018 systematic review and meta-analysis of 8 studies involving a total of 628 participants found some evidence that omega-3 fatty acid supplementation monotherapy improves clinical symptoms and cognitive performances in children and adolescents with ADHD, and that these youth have a deficiency in omega-3 fatty acid levels.The best dosage ratio needs to be further studied, butseveral reported studies suggest a combination of a 9:3:1 ratio EPA, DHA, GLA is associated with improvement in ADHD symptoms.
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