Dear Editor,

Attention deficit hyperactivity disorder (ADHD) is commonly recognized as a neurodevelopmental disease in children and adolescents, which puts a huge economic burden on societies. Its prevalence rate equals to 5–7% in school-aged children worldwide (1, 2). Briefly, a range of clinical manifestations, including inattention, hyperactivity, impulsivity, along with comorbidities such as obesity and sleep disorders have been observed in these children. Sleep problems in ADHD children are almost fivefold more than in the healthy population. In addition, treatment-induced sleep 'disorder' including reduction in total sleep time, decreased sleep efficiency, insomnia, and drowsiness have been reported among them (3).

Common treatment options mainly include pharmacotherapies, as well as behavioral and psychosocial treatments applied separately or in combination. Currently, however, there is an increasing trend in the use of complementary and alternative medicines (CAM) in children with ADHD. A significant number of parents of children diagnosed with ADHD prefer to use CAM alone or in combination with current pharmacotherapy for their children's symptoms. Palliative interventions on ADHD patients have led to symptomatic reliefs, which can greatly improve the quality of life (QOL) in these patients (4, 5). Although the exact term of ADHD is not stated as a distinguished disease in the manuscripts of the traditional Persian medicine (TPM), considering its symptoms and signs, there seem to be some similarities in the clinical manifestations of ADHD and some types of diseases mentioned in TPM sources. One of them is “da'f-I dimāqh” (brain weakness), which is characterized by symptoms of brain dysfunction such as restlessness, difficulty concentrating, sleep disorders and impulsive behavior. In this condition, an accumulation of waste products occurs in the brain due to its inability to excrete them, and results in brain dystepmrament. Therefore, using brain tonics, which are called “muqawwiyat-i dimāqh”, can be helpful in improving these symptoms. There are several nutritional advice and medicinal herbs for the management of brain weakness, which can also be used for palliating ADHD symptoms and improving the patients’ QOL. Some medicinal plants that are brain tonics are shown in Table 1. These plants with strengthening effects on the central nervous system are considered mood and memory enhancers (6, 7). Recent studies have demonstrated the neuroprotective effects of such plants and their impacts on improving the memory functions (8).

Moreover, we presented some dietary programs and appropriate changes in patient’s lifestyle, which will be also supportive for other symptoms such as obesity and sleep disorders in these patients (6,7, 9) (Table 2). However, more clinical studies are required to evaluate the effectiveness of them.

Conflict of interest

None.