The therapeutic role of herbal products and phytochemicals in the management of ADHD: a systematic review
PHYTOCHEMISTRY REVIEWS, cilt.1, sa.1, ss.1-43, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 1 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s11101-026-10315-w
- Dergi Adı: PHYTOCHEMISTRY REVIEWS
- Derginin Tarandığı İndeksler: Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Scopus, Science Citation Index Expanded (SCI-EXPANDED), Chemical Abstracts Core, EMBASE
- Sayfa Sayıları: ss.1-43
- Recep Tayyip Erdoğan Üniversitesi Adresli: Evet
Özet
Herbal products and phytochemicals have attracted increasing interest as alternative or complementary therapies for attention-deficit/hyperactivity disorder (ADHD) because of the limitations of conventional pharmacotherapy. This systematic review evaluated their efficacy and safety in individuals with clinically diagnosed ADHD. Web of Science (WOS), Scopus, and MEDLINE were systematically searched through February 2026. Twenty-six interventional studies investigating 13 herbal products and phytochemicals were included. Risk of bias was independently assessed using validated Cochrane risk of bias tools. Where sufficient data were available, standardized effect sizes (Hedges’ g) with 95% confidence intervals were recalculated and interpreted using a predefined threshold for clinical relevance (SMD ≥ 0.52); otherwise, findings were narratively synthesized. Saffron and Pycnogenol®/pine bark extract (PBE) demonstrated the most promising therapeutic signals. In active-comparator trials, no statistically significant between-group differences were detected between saffron and MPH, while adjunctive studies reported clinically meaningful improvements when saffron was combined with MPH. Pycnogenol®/PBE demonstrated moderate-to-large, often clinically meaningful improvements predominantly in teacher-rated outcomes, whereas corresponding parent-rated outcomes and the only adult trial generally failed to demonstrate comparable benefits. Evidence for ginseng, Ginkgo biloba, polyherbal formulations, Bacopa monnieri, resveratrol, Rosa canina syrup, sweet almond syrup, traditional Chinese medicine formulations, Hypericum perforatum, pigmented corn extract, and Klamin® remained limited, heterogeneous, or insufficient to support firm conclusions. Objective neurocognitive improvements did not consistently translate into improved behavioral ratings. Herbal interventions were generally well tolerated, with predominantly mild-to-moderate adverse events. However, confidence in these findings was limited by high or critical risk of bias, inadequate analytical transparency, missing outcome data, and expectancy bias. Consequently, current evidence is insufficient to recommend any specific herbal product or phytochemical as a standalone or reliable adjunctive treatment for ADHD.