Efficacy of adding acupuncture to Methylphenidate in children and adolescents with attention deficit hyperactivity disorder: A randomized clinical trial

Introduction: Attention deficit hyperactivity disorder (ADHD) is the most prevalent finding in children with behavioral issues. It has been shown that acupuncture, as a complementary medicine, may have some beneficial effects in ADHD treatment; however, the available evidence of its effectiveness are inadequate. This study aimed to investigate the effectiveness of acupuncture treatment in patients with ADHD. Methods: This double blind randomized sham controlled trial was conducted on patients with confirmed ADHD referred to Ibn-e-Sina Psychiatric Hospital, Mashhad, Iran between January 2017 and June 2017. Patients were randomly allocated into either an acupuncture (experimental group) or a sham acupuncture (control group). All patients received a standard treatment of 0.3–1 mg/kg of Methylphenidate (Ritalin) in 2 or 3 divided doses. Within 4 weeks the intervention group received acupuncture treatment 3 times a week. Sham acupuncture was used for the control group within the same duration as acupuncture group. The treatment outcomes were measured using home version of ADHD-rating scale (RS) and the Continuous Performance Test after 3 weeks. Independent-samples t-test, Pearson Chi-square test, and Paired-samples t-test were used for data analysis with SPSS version 16.0. Results: This study was conducted on 59 patients (52 males) with a mean age of 10.64 ± 2.46 years in two groups of experiment (n = 31) and control (n = 28). ADHD-RS total score was significantly more decreased in acupuncture group after 3 weeks (-6.29 ± 7.1 vs. -1.96 ± 6.7; p = 0.007). Also, the hyperactivity and impulsivity was significantly more decreased in the acupuncture group compared to the sham control group (-3.29 ± 3.7 vs. -0.45 ± 4.1; p = 0.005). Furthermore, acupuncture did not considerably change Omission error, Commission error, Reaction Time and Correct hit (p > 0.05). Conclusion: Our study showed that acupuncture can significantly improve the parent-report ADHD-RS. Nevertheless, it did not improve the attention deficit. We recommend further investigations with larger sample sizes and longer follow-up. The adverse effects of acupuncture on ADHD patients were not assessed in this study, but should be measured in future studies