By Will Boggs MD
NEW YORK—Saffron capsules appear to be as effective as methylphenidate for treating children with attention-deficit/hyperactivity disorder (ADHD), researchers from Iran report.
"My research group at Roozbeh Psychiatric Hospital has worked on the psychotropic effects of saffron since early 2000, and we have documented the antidepressant effects of saffron,” Dr. Shahin Akhondzadeh from Tehran University of Medical Sciences told Reuters Health by email.
"On the other hand, many antidepressants have been used as alternative for stimulants in patients with ADHD that cannot tolerate Ritalin (methylphenidate) or do not respond to Ritalin. Therefore, from this preliminary study, the main point is that we can consider saffron just as an alternative in the above mentioned patients," he said.
Saffron (Crocus sativus L.) and its active constituents are thought to increase the reuptake inhibition of dopamine and norepinephrine and are NMDA-receptor antagonists and GABA-alpha agonists.
Dr. Akhondzadeh's team compared the efficacy and safety of saffron capsules versus methylphenidate in their randomized, double-blind pilot clinical trial of 54 children (25 completers in each group) with ADHD.
"We planned to compare with placebo first, but our IRB at Tehran University of Medical Sciences did not allow us to use placebo," Dr. Akhondzadeh explained.
Both saffron and methylphenidate were associated with significant improvements in Parent ADHD Rating Scale scores as early as week 3, with no significant difference between the treatment groups at week 6, the researchers report in the Journal of Child and Adolescent Psychopharmacology, online February 11.
The responder rate (defined as 40% or greater improvement in Parent ADHD Rating Scale scores) did not differ significantly between the saffron (25/25, 100%) and methylphenidate (24/25, 96%) groups, and similar fractions showed marked improvement, defined as at least 50% improvement in Parent ADHD Rating Scale scores) (96% of the saffron group and 84% of the methylphenidate group).
Teacher ADHD Rating Scale scores also showed significant improvement in both groups as early as week 3, with no difference between the treatment groups in total scores or hyperactivity or inattention subscales at weeks 3 and 6.
Teacher ADHD Rating Scale responder rates and marked-improvement rates were similar with saffron (52% and 40%, respectively) and methylphenidate (56% and 48%, respectively).
There were no serious adverse events in either group, and the frequency of side effects did not differ significantly between the groups.
"There are solid documents in the Persian traditional medicine about psychotropic effects of saffron, but we need evidence-based medicine in traditional medicine as well," Dr. Akhondzadeh said.
Dr. Greg W. Mattingly from Washington University School of Medicine in St. Louis, Missouri, who recently co-authored a clinician's guide to ADHD treatment options, told Reuters Health by email, "The fact that saffron improved ADHD symptoms as much as a stimulant was truly impressive! The fact that these improvements in ADHD symptoms were observed both by parents and teachers was especially encouraging."
"The 'holy grail' for families with ADHD is a nonstimulant which works as well as a stimulant," he said. "Even more exciting is when this nonstimulant is a natural product."
"Physicians should be encouraged that a variety of natural compounds are now being explored for their role in treating and improving mental-health conditions," Dr. Mattingly said. "Imagine a world where the foods we eat and the role of natural compounds could improve the lives of patients struggling with a variety of mental health and cognitive conditions."
"These important findings should be explored in larger studies around the world," he said.
J Child Adolesc Psychopharm 2019.
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