Childhood psychological disorders which include diagnoses like Hyperkinetic Syndrome (HKD) or ADHD, ADD, Learning Disabilities, Autism Spectrum disorders, etc., are disorders that homeopathy has successfully treated but not adequately documented. ADHD has existed as a separate diagnosis since 1980 following the publication of the Diagnostic and Statistical Manual Version (DSM) III (Barkley 1990). Today the DSMV IV criteria recognize 3 core signs of inattention, hyperactivity and impulsiveness. They also recognize 3 subgroups: i) Predominantly hyperactive type ii) Predominantly inattentive type iii) a combination of both inattentive and hyperactive impulsivity (APA 2000).
The need is to document adequate research and treatment evidence to support appropriate homeopathic therapeutics of this group of childhood problems. This especially as the number of children affected is growing. Drugs like Methylphenidate (MPD) have numerous side effects and their long term use remains controversial (Timini, 2003). Based on UCD-10 criteria (WHO, 1992) the prevalence in U.K. is about 1%, while with DSMV-IV (APA 2000) the prevalence is about 5%. Homeopathy is more likely to be integrated into the prevailing heath care system (giving people a choice of therapies), if there is clear evidence of its clinical utility in common diseases, and prescribing strategies are simplified (Jacobs: 2000). Richard Liang observing the high quality work done by Frei et al in ADHD, expects that this will “open a new area of homeopathic research which may be called ‘evidence-based’ homeopathy.”(Liang, 2006: 95)
Five articles enumerated below have been chosen for analysis. These have been included as their purpose is documenting evidence for treating ADHD using individualized homeopathy. The author did not find any AHDH trials pertaining to other forms of homeopathic prescribing.
1. Lamont J, (1997); British Homeopathic Journal, (1997) 86; p. 196-200
2. Frie, H, et al (2001); British Homeopathic Journal (2001) 90; p. 183-18.
3. Jacobs et al (2005); J Alternative and Complimentary Medicine (2005) 11:5, p. 779-806 .
4. Frie H, et al; Homeopathy (2006) 95, p. 163-170
5. Frie H, et al; Homeopathy (2007) 96, p. 35-41
All papers are from credible journals that are peer-reviewed. The three papers by Frei et al are a developing assessment of therapeutics and research in ADHD and of excellent homeopathic value, demonstrating an intention to develop research design for ‘evidence-based’ homeopathy while sticking to basic homeopathic principles in Hahnemann’s Organon (1921) and Chronic Diseases (1896). The next step will be to develop a mixed methods study (Cresswell, 2004) where qualitative study and analysis supports quantitative evidence of RCT’s, the author’s interest for future research.
Identification of existing literature on this topic
Databases like Biomed, Medline, Cochrane Library, AMED, EMBASE, CISCOM, ERIC, BIOSIS, included journals like Homeopathy (British Journal of Homeopathy), Complementary Therapeutics in Medicine, Pediatric journals of Europe and North America, Journal of Complementary and Alternative Medicine, etc. and were searched for literature relevant to the topic. Search engines used: Ovid Online, Science Direct, Blackwell Synergy, Wily Interscience, PubMedorrhinum Search words used were ‘homeopath’, ‘hyperactive’, ‘child’, ‘ADHD’ with a restriction to English articles. Any systematic reviews in progress were also included in the search. Those that pertained to non therapeutic discussions were excluded.
Compiled into a word document, relevant articles were explored in detail. Several articles could not be freely accessed or were unavailable electronically. Focused research in ADHD and homeopathy and investigation of the effective alternative treatments for ADHD has been going on over the last 15-20 years, summarized in Table 1. There was one study that identified the use of complex homeopathy for hyperactivity.
Table 1: A summary of studies in ADHD with homeopathy and other alternative forms of medicine.
|Type of Literature||Author, Year, Journal||Title||Objective||Method||Results|
|Homeopathic Trial (Individualized homeopathy)||John Lamont1997|
British Journal of Homeopathy
|Homoeopathic treatment of attention deficit hyperactivity disorder:|
A controlled study
|To determine the effectiveness of homeopathy in ADHD.||Participants were alternately assigned to either placebo or homoeopathic treatment in a double blind, partial crossover study. Medicines or placebos administered to children; after 10 days placebo group were given homoeopathic medicines.||Statistically significant differences were found in comparative scores of each cross over group, supporting the hypothesis that homoeopathic treatment is superior to placebo treatment for ADHD.|
|Homeopathic Trial (Individualized Homeopathy)||H Frei and A Thurneysen2001|
|Treatment for hyperactive children: Homeopathy and methylphenidate compared in a family setting||Purpose of this prospective trial was to assess the efficacy of homeopathy in hyperactive patients and to compare it MPD.||Participants received individual homeopathic treatment; improvement of 50%, parents reevaluated symptoms; did not improve sufficiently changed to MPD, re-evaluated after 3 months.||After an average treatment time of 3.5 months 86 children (75%) had responded to homeopathy, reaching a clinical improvement rating of 73% and an amelioration of the CGI of 55%. Twenty-five children (22%) needed MPD; Results of homeopathic treatment appear to be similar to the effects of MPD|
|Homeopathic Trial (Individualized Homeopathy)||Jacobs J,Williams AL,|
Journal of Alternative and Complementary Medicine
|Homeopathy for attention-deficit/hyperactivity disorder: a pilot randomized-controlled trial.||The aim of this study was to carry out a preliminary trial evaluating the effectiveness of homeopathy in the treatment of attention-deficit/hyperactivity disorder (ADHD)||This work was a randomized, double-blind, placebo-controlled trial. Forty-three subjects were randomized to receive a homeopathic consultation; individualized homeopathic remedy or placebo; Patients seen every 6 weeks for 18 weeks||There were no statistically significant differences between homeopathic remedy and placebo groups on the primary or secondary outcome variables. However, there were statistically and clinically significant improvements in both groups on many of the outcome measures|
|Homeopathic Trial (Individualized Homeopathy)||Frei H,Everts R,|
European Journal of Pediatrics
|Homeopathic Treatment of children with attention deficit hyperactivity disorder: a randomised, double blind, placebo controlled crossover trial||The aim of this study was to obtain scientific evidence of the effectiveness of homeopathy in ADHD||The responders were split into two groups and received either verum for 6 weeks followed by placebo for 6 weeks (arm A), or vice-versa (arm B). Prior to the randomised, double blind, placebo controlled crossover study, they were treated with individually prescribed homeopathic medications.||At entry to the crossover trial, cognitive performance such as visual global perception, impulsivity and divided attention, had improved significantly under open label treatment (P<0.0001). During the crossover trial, CGI parent-ratings were significantly lower under verum (average 1.67 points) than under placebo (P =0.0479). Long-term CGI improvement reached 12 points (63%, P <0.0001)|
|Homeopathic Trial (Individualized Homeopathy)||H Frei,|
K von Ammon A Thurneysen2006Homeopathy
|Treatment of hyperactive children: Increased efficiency through modifications of homeopathic diagnostic procedure||The rigorous test to which homeopathy was subject in previous double-blind clinical trail of homeopathic treatment of attention deficit hyperactivity disorder (ADHD) necessitated optimized treatment meeting the highest standards||Optimization in three steps: (1) In successfully treated, prescriptions of insufficient response analyzed by questionnaire for unreliable symptoms.|
(2) Polarity analysis, introduced in response to one-sided symptoms; specific symptoms to identify remedy genius symptoms to match patient’s characteristics.
(3) Investigated influence of primary perception symptoms on repertorization.
|Introducing the questionnaire, polarity analysis, and including perception symptoms, lead to an improvement in the success rate of the first prescription from 21% to 54%, of the fifth prescription from 68% to 84%|
|Homeopathic Trial (Individualized Homeopathy)||H. Frei, R. Everts, K. von Ammon, F. Kaufmann, D. Walther, S-F Hsu Schmitz, M. Collenberg, M. Steinlin, C. Lim and A. Thurneysen2007|
|Experience with open-label homeopathic treatment preceding the Swiss ADHD placebo controlled, Randomised, double-blind, cross-over trial||Randomised, placebo controlled, cross-over trial with an open-label screening phase prior to the randomised controlled phase; to explore the screening phase data with respect to the risk of failure to demonstrate a specific effect of RCT with randomization at the start.||Screening phase, 84% (70/83) of the children responded to treatment and reached eligibility for the randomized trial after a median time of five months; the difference in Conners Global Index (CGI) rating between responders and non-responders became highly significant (p=0.0006); Improvement in CGI much greater following optimal medication. (p<0.0001).|
|Study of alternative treatments||Arnold LE||Alternative treatments for adults with attention-deficit hyperactivity (ADHD)||Review of evidence in alternative treatments for ADHD||Some alternative Tx of ADHD are effective or probably effective, in some cases, they are the Tx of choice, a few have failed to prove effective in controlled trials, most need research to determine effectiveness.|
|Study of Alternative treatments||Gross-Tsur V,Lahad A,||Use of complementary medicine in children with attention deficit hyperactivity disorder and epilepsy||To identify the prevalence of use, the referral patterns and the perceived benefit of alternative therapy in children with attention-deficit hyperactivity disorder (ADHD)||A mailed questionnaire survey was undertaken in June 1993, of the use of various therapies by families of 381 children with ADHD.||Diet therapies were the most commonly used (60%), non-medicated group reported more benefit from some alternative therapies, physicians commonly involved in modified diet, school teachers, family and friends were the main source of suggestions.|
|Study of various homeopathic methods with identifying food substances contributing to hyperactivity.||Julian N. Kenyon1993|