Clinical evidence on Ayurvedic Management of Attention-Deficit/Hyperactivity Disorder in children and adolescents: A systematic review

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. Ayurveda proposes several therapeutic approaches, including Medhya Rasayana formulations and Panchakarma procedures, for managing ADHD symptoms. This systematic review evaluated the evidence on Ayurvedic management for ADHD in children and adolescents.
Method: A systematic review was conducted following PRISMA guidelines. Electronic databases were searched for studies published between January 2014 and June 2024. Clinical trials, observational studies, case series and open label studies involving Ayurvedic management in children and adolescents with ADHD were included, and methodological quality was assessed using the Jadad scale.
Results: Of 231 identified records, eight studies met the inclusion criteria. Interventions included Bacopa monnieri, Withania somnifera, Saraswatarista, Brahmi Churna, Mandukaparni Churna, and Mentosoothe formulations, Mahapaishacika Ghrta, and Shirodhara-based therapies. Bacopa monnieri improved attention, impulse control, and cognitive performance, with reductions in attention-deficit symptoms reported in up to 85% of children. Saraswatarista significantly improved scholastic performance and interpersonal relationships. Brahmi Churna and Mandukaparni Churna showed benefits in hyperactive-impulsive and inattentive symptoms, respectively, while Withania somnifera reduced anxiety and social concerns. Combined interventions, particularly Vallarai Khiritha with Shirodhara, demonstrated improvements in overall ADHD symptoms. However, methodological quality was limited, with five studies classified as high risk of bias, two as moderate risk, and only one as low risk.
Conclusion: Ayurvedic management show potential benefits in improving behavioural and cognitive symptoms of ADHD; however, larger, high-quality randomized controlled trials are required to establish their efficacy and safety.