PMID- 24374068
OWN - NLM
STAT- MEDLINE
DCOM- 20141211
LR  - 20140204
IS  - 1878-4216 (Electronic)
IS  - 0278-5846 (Linking)
VI  - 50
DP  - 2014 Apr 3
TI  - Moderators of treatment response in adults with ADHD treated with a 
      vitamin-mineral supplement.
PG  - 163-71
LID - S0278-5846(13)00293-5 [pii]
LID - 10.1016/j.pnpbp.2013.12.014 [doi]
AB  - BACKGROUND: To date there has been no research investigating moderators of 
      response to micronutrient treatment of mental illness, specifically baseline 
      nutrient levels. METHOD: We conducted analyses of data from a randomized 
      placebo-controlled trial (RCT) of 80 adults (>/=16years) with 
      Attention-Deficit/Hyperactivity Disorder (ADHD), whereby participants were 
      treated acutely (8weeks) with micronutrients or placebo followed by an open-label 
      (OL) phase of 8weeks whereby all participants received micronutrients. To ensure 
      that all participants had been exposed to the micronutrients for 8weeks, only 
      those 64 who had adhered to the treatment protocol and completed 8weeks on 
      nutrients were included in the data analysis: 34 from the group that had been 
      randomized to the micronutrient arm, and 30 from the group that had been 
      randomized to the placebo group and hence had only received nutrients in the OL 
      phase. Six outcomes were examined: change in ADHD symptoms (self/clinician), ADHD 
      responder, Clinical Global Impression-Improvement (CGI-I), change in mood, and 
      change in Global Assessment of Functioning (GAF). Demographic, developmental and 
      psychiatric history, current clinical characteristics, and baseline nutrient 
      levels were all considered as putative predictors. RESULTS: There were 
      significant changes in all outcome variables after 8weeks exposure to the 
      micronutrients. Among the nutrients recorded at baseline, substantial 
      deficiencies (27%) were only observed for vitamin D. However, other than an 
      association showing that higher iron at baseline was correlated with higher 
      baseline depression scores, baseline nutrient levels were not correlated with 
      baseline psychiatric variables/current clinical characteristics. Regression 
      analyses revealed that higher baseline ferritin and lower baseline copper and 
      vitamin D levels were associated with a better response to treatment for some but 
      not all outcomes. None of the other nutrient levels was found to be associated 
      with outcome, including zinc, vitamin B12, iron, and folate. There were no 
      childhood risk factors, demographic variables or clinical correlates that 
      contraindicated micronutrient treatment; more severe symptoms at baseline and 
      greater number of developmental risk factors predicted greater treatment 
      response. CONCLUSIONS: Further research looking at nutrients more broadly is 
      required to confirm these initial observations about ferritin, vitamin D and 
      copper; however, the results suggest that serum nutrient levels have limited 
      value for identifying who will respond to treatment.
CI  - Copyright (c) 2013 Elsevier Inc. All rights reserved.
FAU - Rucklidge, Julia J
AU  - Rucklidge JJ
AD  - Department of Psychology, University of Canterbury, Christchurch, New Zealand. 
      Electronic address: julia.rucklidge@canterbury.ac.nz.
FAU - Johnstone, Jeanette
AU  - Johnstone J
AD  - Department of Psychology, University of Canterbury, Christchurch, New Zealand.
FAU - Gorman, Brigette
AU  - Gorman B
AD  - Department of Psychology, University of Canterbury, Christchurch, New Zealand.
FAU - Boggis, Anna
AU  - Boggis A
AD  - Canterbury District Health Board, Christchurch, New Zealand.
FAU - Frampton, Christopher M
AU  - Frampton CM
AD  - Department of Psychological Medicine, University of Otago, Christchurch, New 
      Zealand.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20131226
PL  - England
TA  - Prog Neuropsychopharmacol Biol Psychiatry
JT  - Progress in neuro-psychopharmacology & biological psychiatry
JID - 8211617
RN  - 0 (Micronutrients)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Affect/drug effects
MH  - Aged
MH  - Attention Deficit Disorder with Hyperactivity/*drug therapy
MH  - Double-Blind Method
MH  - Female
MH  - Humans
MH  - Male
MH  - Micronutrients/adverse effects/*therapeutic use
MH  - Middle Aged
MH  - Psychiatric Status Rating Scales
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - ADHD
OT  - Micronutrients
OT  - Minerals
OT  - Predictors
OT  - Treatment
OT  - Vitamins
EDAT- 2014/01/01 06:00
MHDA- 2014/12/17 06:00
CRDT- 2013/12/31 06:00
PHST- 2013/10/10 00:00 [received]
PHST- 2013/12/18 00:00 [revised]
PHST- 2013/12/18 00:00 [accepted]
PHST- 2013/12/31 06:00 [entrez]
PHST- 2014/01/01 06:00 [pubmed]
PHST- 2014/12/17 06:00 [medline]
AID - S0278-5846(13)00293-5 [pii]
AID - 10.1016/j.pnpbp.2013.12.014 [doi]
PST - ppublish
SO  - Prog Neuropsychopharmacol Biol Psychiatry. 2014 Apr 3;50:163-71. doi: 
      10.1016/j.pnpbp.2013.12.014. Epub 2013 Dec 26.