Bottom Line
Homeopathy is a safe and often effective natural therapy for children (and adults) with attention deficit disorder and attention deficit/hyperactivity disorder (ADD/ADHD) and its associated symptoms. There have now been several studies that have confirmed significant results from homeopathic treatment, though no single protocol for homeopathic treatment has been replicated and shown to have efficacy. Homeopathic primary care can be effective, though this condition is best treated by a professional homeopath.

It is initially surprising and confusing to learn that the most common conventional drug for children with hyperactivity is an amphetaminelike drug called Ritalin. One would think that this type of drug would make hyperactive children even more hyperactive. But it doesn't. This treatment of using a medicine that causes symptoms similar to those that the patient has is actually the basic principle of homeopathy. That said, in actual homeopathy, much smaller and safer doses of medicines are used; plus each medicine is individualized to the patient.

Hyperactivity and the various syndromes that doctors have termed this condition (ADD/ADHD) have become Ameri­ca's number one childhood psychiatric ailment. Ritalin has become so common that some people are calling it "vitamin R."

The reason that homeopaths do not prescribe Ritalin is that they are worried about the short-term side effects and the long-term consequences of its use. Even Newsweek (March 18, 1996) noted: "There are no definitive long-studies to reassure parents that this stimulant isn't causing some hidden havoc to their child." The FDA did, however, recently report on a study that showed that it caused a rare form of liver cancer in mice.

As for the short-term problems from Ritalin, children common report loss of sleep, stomach pains, irritability, and (sometimes even) facial tics. Despite these risks, it should also be acknowledged that Ritalin is effective for many children. However, it makes sense to try safer methods before resorting to more potentially dangerous ones.

In addition to the safety issues, homeopaths find homeopathic medicines to be effective when individually prescribed to a child and his or her unique pattern of symptoms. In fact, a couple of impressive studies have found significant results using homeopathic medicines. In addition to this study, most homeopaths regularly see children and adults with ADD/ADHD. For further information and insight into the homeopathic approach to this condition, see Ritalin-Free Kids by Judyth Reichenberg-Ullman, ND, LCSW, DHANP, and Robert Ullman, ND, DHANP (see "Resources," below).

A Study Comparing Homeopathic Treatment and Ritalin
A unique study in Switzerland evaluated 115 children (92 boys, 23 girls) with an average age of 8.3 years at diagnosis of ADD/ADHD (Frei and Thurneysen 2001). The children were first treated with an individually chosen homeopathic medicine. Those who did not improve sufficiently on homeopathy were changed to Ritalin and evaluated after 3 months. After an average treatment time of 3.5 months, 75% of the children responded favorably to homeopathy, attaining an improvement rating of 73%. Twenty-two percent of the children were treated with Ritalin and attained an improvement rating of 65%. The children were also evaluated according to the Conners Global Index (CGI), a recognized scale that measures the degree of hyperactivity and attention deficit symptoms. The children who responded to the homeopathic medicine experienced a 55% amelioration of the CGI, while the children who responded to Ritalin experienced a 48% lowering of the CGI. Three children didn't respond to homeopathy or Ritalin, and one child left the study before completion. The researchers concluded that homeopathic treatment was comparable in its benefits with Ritalin.

A Major Study Published in the European Journal of Pediatrics
Two studies, a randomized, partially blinded trial and a clinical observation study, have concluded that homeopathy has positive effects in patients with ADHD (Frei, Everts, von Ammon, et al. 2005). A total of 83 children aged 6–16 years, with ADHD diagnosed using the criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV), were recruited. Prior to the randomized, double-blind, placebo-controlled crossover study, they were treated with individually prescribed homeopathic medications. The 62 patients, who achieved an improvement of 50% in the Conners' Global Index (CGI), participated in the trial. Thirteen patients did not fulfill this eligibility criterion (CGI). The responders were split into two groups and received either verum for 6 weeks followed by placebo for 6 weeks (arm A), or vice versa (arm B). At the beginning of the trial and after each crossover period, parents reported the CGI and patients underwent neuropsychological testing. The CGI rating was evaluated again at the end of each crossover period and twice in long-term follow-up. At entry to the crossover trial, cognitive performance such as visual global perception, impulsivity, and divided attention had improved significantly under open label treatment (p < 0.0001). During the crossover trial, CGI parent-ratings were significantly lower (this means the child was "better") under homeopathic treatment (average 1.67 points) than under placebo (p = 0.0479). Long-term (defined as 14 weeks) CGI improvement reached 12 points (63%; p < 0.0001).

The long-term improvement from individualized homeopathic treatment of children with ADHD was substantially significant. The trial suggests scientific evidence of the effectiveness of homeopathy in the treatment of ADHD, particularly in the areas of behavioral and cognitive functions.

In a later paper, the authors of the above study described the steps that they took to improve the success rate in the homeopathic treatment of children with ADD/ADHD (Frei, Ammon, and Thurneysen 2006). The clinicians in this study utilized the "Boenninghausen method," which tends to emphasize physical symptoms and the various modalities that aggravate or ameliorate them, rather than the emotional or behavioral symptoms as more typically do other styles of selecting homeopathic medicines for individualized treatment. These researchers also prescribed homeopathic potencies called "LM potencies," which generally require more frequency of dosing, and found better compliance from parents when compared with the single-dose regimen that is commonly used by other homeopaths.

A Double-Blind Study Comparing Homeopathy and Placebo
John Lamont, PhD, a psychologist in Southern California, conducted a trial of 43 children with ADHD (Lamont 1997). He randomly assigned half of the children to receiving a placebo and the other half to homeopathic treatment. The researcher, the parents, and the children did not know which child was given the homeopathic medicine or the placebo.

The evaluations of improvement were based on parent or caretaker ratings of ADHD behaviors. A simple 5-point scale was used: Much worse (−2); a little worse (−1); no change (0); a little better (+1); much better (+2). Parents or caretakers were contacted by telephone 10 days after remedy/placebo taken and again after 2 months.

To avoid any potential influence from the homeopath, he had no further contact with children except during the initial testing and case-taking interview. Even the medicine was not given directly to the patient by the homeopath but sent via the mail.

All children in the experiment came from foster homes or from parents under the supervision of social workers. The average age was 10, and there was a mixture of races: 47% Hispanic, 35% black, and 18% Caucasian.

The children were only accepted into the trial if they fit the specific criteria for ADHD as determined by the DSM-IV. Children who were on medication for ADHD could be accepted for the study but only if they had been on this medication for at least six weeks. The latter condition was determined because Lamont didn't consider it wise to admit children who were new to medication in the trial, since it then could not be ascertained if their improvement was the result of their conventional or homeopathic medicine.

Half of the children were given an individualized homeopathic medicine and half were given a placebo that resembled a homeopathic medicine for 10 days. After this, the half given a placebo were given an individualized homeopathic medicine. Neither the children nor their parents were told that they might be given a placebo because the researcher did not want to influence them with the knowledge that the second round of medicines would be the "real" ones.

Only the 200c potency of an individualized homeopathic medicine was used, based on the homeopath's small pilot study of 15 patients in which a trend was observed that the 200c was more effective than 30c.

The Results
The mean improvement scores after 10 days were 0.35 for the placebo group and 1.00 for the homeopathically treated group (p = 0.05). The greatest improvements were noticed by the third day, while a smaller number showed improvement after 10 days.

Children who were initially given a placebo were given a homeopathic prescription after 10 days and then compared with their earlier score. The mean improvement scores were 0.35 for the placebo group and 1.13 after a homeopathic medicine was given (p = 0.02).

When parents reported that improvement from the treatment was not obvious, the homeopath prescribed a second or a third remedy. When comparing the results after these remedies, improvement from the homeopathic group was 1.63 and from the placebo group was 0.35 (p = 0.01).

Besides the improvement 10 days after the homeopathic medicine, follow-up interviews observed that the majority of children who were treated homeopathically experienced sustained and increased improvement in their condition. In total, after 2 months, 57% of children experienced continued improvement; 24% showed improvement for several days or weeks follow­ing homeopathic treatment but relapsed by the 2-month interview. 19% said that they only observed improvement while taking homeopathic treatment (one could guess that this im­provement was primarily from the placebo effect).

A second homeopathic remedy was given to 18 of 43 subjects, and 7 required a third remedy. Phone calls were made 10 days after each remedy, and if it seemed that the remedy was not working, a different medicine would be prescribed.

Only three children were dropped from the trial, and this was the result of changes in dosage of anti-ADHD prescription after homeopathic treatment.

In summary, this study showed that the effects of the homeopathic medicine were relatively rapid (usually within 3 days), and a 2-month follow-up found that 57% of the children experienced sustained and increased improvement.

The Cochrane Database has reviewed the above research and asserted, "There is currently little evidence for the efficacy of homeopathy for the treatment of ADHD" (Coulter and Dean 2007). However, the Cochrane Database maintains a very high standard for its definition of "efficacy." It is important to note that it stated that there was "little evidence," not "no evidence," that homeopathic medicines have been shown to be effective in the treatment of children with ADD/ADHD.

The Medicines Used
Lamont used a homeopathic software program to aid his selection of the individualized medicine. These sophisticated programs are increasingly used to improve both the speed and accuracy of prescribing homeopathic remedies, and they are now used by the majority of full-time practicing homeopaths in the US.

The following descriptions of the five most common homeopathic medicines used in this study are not provided to encourage self-diagnosis or prescribing. Because chronic ailments are best treated by a professional homeopath, children with ADHD or its related conditions should be seen by one. These descriptions provide insight into the important concept within homeopathy that asserts that people do not simply have "diseases," but "syndromes" of symptoms of which the disease is a part.

It is remarkable that so many people today incorrectly think that those with the same disease should be given the same medicine. In homeopathy, once a conventional diagnosis is made, the practitioner evaluates the case in greater detail to see what individualizing and unique symptoms each patient manifests.

• Stramonium (thorn apple or Datura stramonium): The most commonly indicated remedy that Lamont found for children with ADHD was Stramonium. It represented 35% of the patients he treated. Children who need this medicine are known to experience extreme fears and exhibit violent behaviors. They are especially fearful of the dark, animals, and water. They are easily startled and will automatically, even unconsciously, respond with rage beyond proportion to the initiating event, as though it was an animalistic, primordial response. These tantrums may include stammering, cursing, and hitting. These intense children may also become extremely clingy toward their parents, do not want to be alone, and may have strong feelings of jealousy.
  
  Most of the time children develop the need for Stramonium from unknown events, though homeopaths have also found that certain birth traumas, violent abuse (physical or sexual), or other traumatic occurrences may lead to the symptoms that Stramonium can effectively cure.
  
  
• Cina (wormseed): The next most common remedy used in this study was Cina, represent­ing 19% of the children. Children who need Cina are extremely irritable and physically aggressive. They are prone to fighting and arguing and tend to have tantrums when they are disciplined or simply told to do something. They are disposed to biting, kicking, pinching, and screaming. They like and benefit from being rocked but don't like being touched, carried (except over the shoulder), or even looked at. Cina is a leading homeopathic medicine for pinworms. If a child has pinworms and ADHD, Cina should be seriously considered.
  
  
• Hyoscyamus (henbane) is also a common remedy for children with ADHD. Like Cina, it represented 19% of the children in this experiment. Hyoscyamus is typically indicated when children exhibit sexualized symptoms of any type or when they have manic symptoms of various sorts, such as pressured speech, great loquacity, extreme silliness, or very high energy. These children tend to be quarrelsome and obscene. They will curse, expose themselves, or, less often, act seductively. They are also known to be very jealous, especially when a younger sibling is born. This jealousy may even lead to malicious violence against this younger sibling. Bedwetting may be an additional concurrent complaint.
  
  Tarentula hispanica (Spanish spider) is indicated when children exhibit endless physical activity. These children are always active, always in motion. They are hurried and impa­tient, and they are soothed and hypnotized by music. They love to hear music and to dance. They tend to have a good sense of rhythm and desire to play various instruments. However, these children tend to be destructive of anything that they get their hands on. They even tend to rip and destroy their own clothes. They need to be watched very carefully, though they can be irritated if they know they are being watched.
  
  
• Veratrum album (white hellebore) is good for restless chil­dren who have difficulty maintaining concentration, following directions, or staying at their desks. These children are constantly busy and hurried and have the unusual desire to touch and/or kiss anything. These children tend to engage in repetitive behaviors, such as stacking blocks or cutting or tearing things. They are "know-it-alls" and can be bossy, self-righteous, and argumentative.

References
Coulter M, Dean M. Homeopathy for attention deficit/hyperactivity disorder or hyperkinetic disorder. Cochrane Database Syst Rev. 2007 Oct 17;(4).

Frei H, Everts R, von Ammon K, et al. Homeopathic treatment of children with attention deficit hyperactivity disorder: a randomised, double blind, placebo controlled crossover trial. Eur J Pediatr. July 27 2005;164:758–767.

Frei H, Thurneysen A. Treatment for hyperactive children: homeopathy and methylphenidate compared in a family setting. Br Homeopath J. October 2001;90:183–188.

Frei H, von Ammon K, Thurneysen A. Treatment of hyperactive children: increased efficiency through modifications of homeopathic diagnostic procedure. Homeopathy. July 2006;95:163–170.

Lamont J. Homeopathic treatment of attention deficit hyperactivity disorder. Br Homeopath J. October 1997;86:196–200.

Resources
Herscu, Paul. Stramonium. Amherst: New England School of Homeopathy Press; 1996.

Prozac Free: Homeopathic Alternatives to Conventional Drug Treatment. Berkeley: North Atlantic; 2002.

Ullman, Dana. The Consumer's Guide to Homeopathy. New York: Jeremy Tarcher/Putnam; 1996.

Homeopathic Medicines for Children and Infants. New York: Jeremy Tarcher/Putnam; 1992.

Dana Ullman, MPH, is "homeopathic.com" and is widely recognized as a leading spokesperson for homeopathic medicine in the US. He has authored nine books, including America’s most popular homeopathic clinical guidebook, Everybody’s Guide to Homeopathic Medicines (Jeremy Tarcher/Putnam; revised 2004). He has recently completed a new book, The Homeopathic Revolution: Why Famous People & Cultural Heroes Choose Homeopathy (North Atlantic Books; 2007).

Dana Ullman, MPH
Homeopathic Educational Services
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