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CNS & Neurological Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5273
ISSN (Online): 1996-3181

Clinical Trial

Coenzyme Q10 in the Treatment of Attention Deficit Hyperactivity Disorder in Children: A Randomized Controlled Trial

Author(s): Fatma Gamal*, Osama El Agami and Abeer Salamah

Volume 21, Issue 8, 2022

Published on: 12 January, 2022

Page: [717 - 723] Pages: 7

DOI: 10.2174/1871527320666211124093345

Price: $65

Abstract

Background: Attention Deficit Hyperactivity Disorder is a common child neurobehavioral disorder whose pathogenesis is not completely understood. However, some evidence indicates a crucial link between this disorder and the degree of oxidative stress. Coenzyme Q10 (ubiquinol) is an antioxidant that may play a significant role in the treatment of Attention Deficit Hyperactivity Disorder.

Objective: To assess the safety and efficacy of coenzyme Q10 as an add-on drug treatment for attention deficit hyperactivity disorder.

Methods: Sixty children, aged 6-16 years, with attention deficit hyperactivity disorder, non-responders to atomoxetine treatment for 6 months, were included in this double-blind, randomized, and controlled study. Group 1 received atomoxetine plus coenzyme Q10, and group 2 received atomoxetine plus placebo for 6 months. Follow-up by CONNERS parent rating scale questionnaire (CPRS-48) was performed before and after 1, 3, and 6 months of treatment, and any drug-related side effects were reported.

Results: The addition of coenzyme Q10 to atomoxetine in group 1 improved symptoms in a shorter time with minimal adverse effects. Group 1 showed improvement of about 33.87% in CPRS-48 total score versus 18.24% in group 2. There was a statistically significant decrease in CPRS-48 total score and its three subscales (learning problems, impulsive hyperactive subscale, and 10-items hyperactivity index) in group 1 versus group 2 after six months of treatment (p-value <0.001).

Conclusion: Coenzyme Q10 has an important role as an add-on drug treatment for attention deficit hyperactivity disorder by improving symptoms, particularly hyperactivity, and in minimizing atomoxetine adverse effects.

Keywords: ADHD, coenzyme Q10, attention, antioxidants, oxidative stress, atomoxetine.

Graphical Abstract

[1]
Cabral MDI, Liu S, Soares N. Attention-deficit/hyperactivity disorder: diagnostic criteria, epidemiology, risk factors and evaluation in youth. Transl Pediatr 2020; 9(Suppl. 1): S104-13.
[http://dx.doi.org/10.21037/tp.2019.09.08] [PMID: 32206588]
[2]
Ayano G, Yohannes K, Abraha M. Epidemiology of Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents in Africa: A systematic review and meta-analysis. Ann Gen Psychiatry 2020; 19: 21.
[http://dx.doi.org/10.1186/s12991-020-00271-w] [PMID: 32190100]
[3]
Magnus W, Nazir S, Anilkumar AC, Shaban K. Attention deficit hyperactivity disorder. In: StatPearls. Treasure Island, FL: StatPearls Publishing 2020.
[4]
Ledbetter M. Atomoxetine: a novel treatment for child and adult ADHD. Neuropsychiatr Dis Treat 2006; 2(4): 455-66.
[http://dx.doi.org/10.2147/nedt.2006.2.4.455] [PMID: 19412494]
[5]
Bloch MH, Mulqueen J. Nutritional supplements for the treatment of ADHD. Child Adolesc Psychiatr Clin N Am 2014; 23(4): 883-97.
[http://dx.doi.org/10.1016/j.chc.2014.05.002] [PMID: 25220092]
[6]
Cobley JN, Fiorello ML, Bailey DM. 13 Reasons why the brain is susceptible to oxidative stress. Redox Biol 2018; 15: 490-503.
[http://dx.doi.org/10.1016/j.redox.2018.01.008] [PMID: 29413961]
[7]
Joseph N, Zhang-James Y, Perl A, Faraone SV. Oxidative stress and ADHD: a meta-analysis. J Atten Disord 2015; 19(11): 915-24.
[http://dx.doi.org/10.1177/1087054713510354] [PMID: 24232168]
[8]
Verlaet AAJ, Maasakkers CM, Hermans N, Savelkoul HFJ. Rationale for dietary antioxidant treatment of ADHD. Nutrients 2018; 10(4): 405.
[http://dx.doi.org/10.3390/nu10040405] [PMID: 29587355]
[9]
Salama M, Yuan TF, Machado S, et al. Co-enzyme Q10 to treat neurological disorders: Basic mechanisms, clinical outcomes, and future research direction. CNS Neurol Disord Drug Targets 2013; 12(5): 641-64.
[http://dx.doi.org/10.2174/18715273113129990071] [PMID: 23574157]
[10]
Perera B, Courtenay K, Solomou S, Borakati A, Strydom A. Diagnosis of attention deficit hyperactivity disorder in intellectual disability: diagnostic and statistical manual of mental disorder V versus clinical impression. J Intellect Disabil Res 2020; 64(3): 251-7.
[http://dx.doi.org/10.1111/jir.12705] [PMID: 31808234]
[11]
Catale C, Geurten M, Lejeune C, Meulemans T. The conners parent rating scale: psychometric properties in typically developing 4- to 12-year-old Belgian French-speaking children. Eur Rev Appl Psychol 2014; 64: 221-7.
[http://dx.doi.org/10.1016/j.erap.2014.07.001]
[12]
Hershey AD, Powers SW, Vockell AL, et al. Coenzyme Q10 deficiency and response to supplementation in pediatric and adolescent migraine. Headache 2007; 47(1): 73-80.
[http://dx.doi.org/10.1111/j.1526-4610.2007.00652.x] [PMID: 17355497]
[13]
Kratochvil CJ, Vaughan BS, Stoner JA, et al. A double-blind, placebo-controlled study of atomoxetine in young children with ADHD. Pediatrics 2011; 127(4): e862-8.
[http://dx.doi.org/10.1542/peds.2010-0825] [PMID: 21422081]
[14]
Goyette CH, Conners CK, Ulrich RF. Normative data on revised conners parent and teacher rating scales. J Abnorm Child Psychol 1978; 6(2): 221-36.
[http://dx.doi.org/10.1007/BF00919127] [PMID: 670589]
[15]
Spencer T, Biederman J, Wilens T, et al. A large, double-blind, randomized clinical trial of methylphenidate in the treatment of adults with attention-deficit/hyperactivity disorder. Biol Psychiatry 2005; 57(5): 456-63.
[http://dx.doi.org/10.1016/j.biopsych.2004.11.043] [PMID: 15737659]
[16]
Spencer T, Biederman J, Heiligenstein J, et al. An open-label, dose-ranging study of atomoxetine in children with attention deficit hyperactivity disorder. J Child Adolesc Psychopharmacol 2001; 11(3): 251-65.
[http://dx.doi.org/10.1089/10445460152595577] [PMID: 11642475]
[17]
Brown KA, Samuel S, Patel DR. Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: a review for practitioners. Transl Pediatr 2018; 7(1): 36-47.
[http://dx.doi.org/10.21037/tp.2017.08.02] [PMID: 29441281]
[18]
Alvarez-Arellano L, González-García N, Salazar-García M, Corona JC. Antioxidants as a potential target against inflammation and oxidative stress in attention-deficit/hyperactivity disorder. Antioxidants 2020; 9(2): 9.
[http://dx.doi.org/10.3390/antiox9020176] [PMID: 32098021]
[19]
Gvozdjáková A, Kucharská J, Ostatníková D, Babinská K, Nakládal D, Crane FL. Ubiquinol improves symptoms in children with autism. Oxid Med Cell Longev 2014; 2014: 798957.
[http://dx.doi.org/10.1155/2014/798957] [PMID: 24707344]
[20]
Homidi M, Obaidat Y, Hamaidi D. Prevalence of attention deficit and hyperactivity disorder among primary school students in Jeddah city, KSA. Life Sci J 2013; 10: 280-5.
[21]
Zorlu A, Unlu G, Cakaloz B, Zencir M, Buber A, Isildar Y. The prevalence and comorbidity rates of ADHD among school-age children in Turkey. J Atten Disord 2020; 24(9): 1237-45.
[http://dx.doi.org/10.1177/1087054715577991] [PMID: 25846229]
[22]
Childress AC. A critical appraisal of atomoxetine in the management of ADHD. Ther Clin Risk Manag 2015; 12: 27-39.
[http://dx.doi.org/10.2147/TCRM.S59270] [PMID: 26730199]
[23]
Wernicke JF, Kratochvil CJ. Safety profile of atomoxetine in the treatment of children and adolescents with ADHD. J Clin Psychiatry 2002; 63(Suppl. 12): 50-5.
[PMID: 12562062]

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