Higher Doses of EPA Improves ADHD Inattentive symptoms

I have written before about the Omega-3 fatty acids for the treatment of ADHD Inattentive as well as other forms of ADHD. It turns out that a recent review of the medical literature has found that it is the EPA rather than the DHA amounts in the Omega-3 fatty acids that most improve the symptoms of ADHD.

The researchers of a review paper published this month in the Journal of the American Academy of Child and Adolescent Psychiatry looked at ten trials involving 700 children and found that supplementation with Omega-3 fatty acids demonstrated a small but significant effect in improving the symptoms of ADHD and that the amount of Eicosapentaenoic acid (EPA) within the supplement was significantly correlated with the effect of the supplement.

This is very new information. Up to this point we thought that it was the total amount of Omega-3 that made the difference. This report advises that it is the EPA within the Omega-3 that matters. The amount of EPA in Krill oil is minimal. There are supplements that contain a lot more EPA than the Krill Oil including CorOmega for kids and MorEpa for adults.

I have switched my inattentive son and me from the Krill oil to the MorEpa. The Krill oil has the phophatidyl Serine that has been shown in some studies to be helpful for the symptoms of ADHD but the data behind the EPA is, at this point, stronger than the data showing benefits from the Phophatidyl and I believe strongly in following the data.

This table from the American Heart Association gives you the amounts of EPA and DHA in your most popular Omega-3 supplements. One of the problems with many of these supplements is that the fish oil gives you bad breath and fish burps. The MorEpa and the CorOmega products are both flavored in such a way that these side effects are minimized.

The abstract of the  new study can be found under the fish supplement table.  Send me your thoughts and let me know how you are doing.
Fish Oil Supplements
Supplement NameAmount of EPA, DHA (in one soft gel or capsule)
Carlson Super Omega-3 Fish Oils300mg EPA, 200mg DHA
Carlson® Norwegian Cod Liver Oil460-500 mg EPA, 500-550 mg DHA per 5 ml liquid
Coromega™ Omega-3 Fish Oil350 mg EPA, 230 mg DHA per packet
CVS® Natural Fish Oil Concentrate 1000 mg180 mg EPA, 120 mg DHA
GNC Preventive Nutrition® Omega Complex60 mg EPA, 40 mg DHA
Dale Alexander® Omega-3 Fish Oil Concentrate234mg EPA, 125mg DHA
Health from the Sun: The Total EFA™ Essential Fatty Acid Dietary Supplement72mg EPA, 46mg DHA
Nature's Bounty® Cold Water Salmon Oil 1000 mg80 mg EPA, 120 mg DHA
Nature's Bounty® Natural Fish Oil 1000 mg Cholesterol Free180 mg EPA, 120 mg DHA
OLAY™ vitamins essential balanced omega 3/6™, Enteric Coated for Better Digestion93.6 mg EPA, 187 mg DHA
OmegaBrite 100% Natural Advanced Omega 3 Formula, 500 mg375 mg EPA, 55 mg DHA
PhytoPharmica® ESKIMO-3® Naturally Stable Fish Oil®70 mg EPA, 42 mg DHA
Puritan's Pride® Cholesterol Free Fish Oil 1200 mg216 mg EPA, 144 mg DHA
Puritan's Pride® Cholesterol Free Natural Fish Oil EPA 1000 mg180 mg EPA, 120 mg DHA
Puritan's Pride® Triple Omega 3-6-9 Flax, Fish and Borage Oil120 mg EPA, 80 mg DHA
Rexall® Flax, Fish, Borage Oil120 mg EPA, 80 mg DHA
Spring Valley Fish Oil 1200 mg216 mg EPA, 144 mg DHA
Sundown® Fish Oil 100 mg180 mg EPA, 120 mg DHA
The Vitamin Shoppe™ Essential Oils & Fatty Acids EPA-DHA Omega-3 Fish Oil 500
300 mg EPA, 200 mg DHA
Triomega® Omega-3333,3ng EPA, 167 DHA
Vitamin World® Cholesterol Free Fish Oil 1200 mg216 mg EPA, 144 mg DHA
Vitamin World® Naturally Inspired™ Omega-3 Fish Oil 1000mg Cholesterol-Free180 mg EPA, 120 mg DHA
Vitamin World® Naturally Inspired™ Super EPA Natural Fish Oil 1000 mg Cholesterol-Free300 mg EPA, 200 mg DHA
Vitamin World® Triple Omega 3-6-9 Flax, Fish & Borage Oil120 mg EPA, 80 mg DHA

J Am Acad Child Adolesc Psychiatry. 2011 Oct;50(10):991-1000. Epub 2011 Aug 12.

Omega-3 Fatty Acid supplementation for the treatment of children withattention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis.


Yale Child Study Center and Yale University.



Several studies have demonstrated differences in omega-3 fatty acid composition in plasma and in erythrocyte membranes in patients with attention-deficit/hyperactivity disorder (ADHD) compared with unaffected controls. Omega-3 fatty acids have anti-inflammatory properties and can alter central nervous system cell membrane fluidity and phospholipid composition. Cell membrane fluidity can alter serotonin and dopamine neurotransmission. The goal of this meta-analysis was to examine the efficacy of omega-3 fatty acid supplementation in children with ADHD.


PubMed was searched for randomized placebo-controlled trials examining omega-3 fatty acid supplementation in children with ADHD symptomatology. The primary outcome measurement was standardized mean difference in rating scales of ADHD severity. Secondary analyses were conducted to determine the effects of dosing of different omega-3 fatty acids in supplements.


Ten trials involving 699 children were included in this meta-analysis. Omega-3 fatty acid supplementation demonstrated a small but significant effect in improving ADHD symptoms. Eicosapentaenoic acid dose within supplements was significantly correlated with supplement efficacy. No evidence of publication bias or heterogeneity between trials was found.


Omega-3 fatty acid supplementation, particularly with higher doses of eicosapentaenoic acid, was modestly effective in the treatment of ADHD. The relative efficacy of omega-3 fatty acid supplementation was modest compared with currently available pharmacotherapies for ADHD such as psychostimulants, atomoxetine, or α(2) agonists. However, given its relatively benign side-effect profile and evidence of modest efficacy, it may be reasonable to use omega-3 fatty supplementation to augment traditional pharmacologic interventions or for families who decline other psychopharmacologic options.

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