Does it work?

Methylphenidate (Ritalin, Concerta) and amphetamines (Adderall, Vyvanse) beat placebo clearly, whether you, your doctor or a neutral observer judges. In adults the effect is medium-sized.

Large population studies also link being on medication with fewer accidents, injuries and deaths. Side effects such as lower appetite, poorer sleep and a small rise in pulse and blood pressure are common, so a doctor adjusts the dose and checks your heart readings.

Stimulants carry an FDA warning about misuse and addiction: store them safely and never share them.

• Ostinelli, Cortese et al., Lancet Psychiatry (113 trials in adults) (2025)
• Cortese et al., Lancet Psychiatry (network meta-analysis) (2018)
• Li et al., JAMA (medication and death rates, 148,578 people) (2024)

In children, atomoxetine (Strattera), viloxazine (Qelbree), guanfacine (Intuniv) and clonidine all beat placebo. In adults the clearest evidence is for atomoxetine; viloxazine is also approved for adults, while guanfacine and clonidine are approved in the US for children only.

Effects are smaller on average than stimulants, and more people stop atomoxetine and guanfacine than placebo. They are not controlled drugs, so the stimulant shortage does not affect them.

Atomoxetine and viloxazine carry an FDA warning about suicidal thoughts in children and teens, so watch for mood changes, especially early on. Guanfacine and clonidine lower blood pressure and pulse rather than raising them, and must not be stopped suddenly because blood pressure can rebound.

• Ostinelli, Cortese et al., Lancet Psychiatry (113 trials in adults) (2025)
• Gosling, Cortese et al., BMJ umbrella review of ADHD treatments (2025)
• Farhat et al., Lancet Psychiatry (heart effects of ADHD medicines) (2025)

ADHD-focused CBT teaches concrete skills: one calendar and task system, breaking tasks down, planning the first step, and handling the thoughts that lead to putting things off. Trials show a moderate improvement in symptoms.

The 2025 review found the benefit showed up clearly when clinicians rated it and less when patients did, so expect real but not dramatic change.

• Knouse et al., meta-analysis of CBT for adult ADHD (2017)
• Ostinelli, Cortese et al., Lancet Psychiatry (113 trials in adults) (2025)

Behavioural parent training teaches routines, clear instructions, praise and consistent consequences. It improves behaviour and home life in blinded studies, and the American Academy of Pediatrics recommends it first for children under 6.

Its effect on the core ADHD symptoms themselves is more modest.

• Doffer et al., JCPP Advances (2023)
• American Academy of Pediatrics ADHD guideline (2019)

In a trial of 244 children, two short sessions on bedtime routines and sleep habits improved sleep, ADHD symptoms, behaviour and parents’ wellbeing. Melatonin helps children fall asleep sooner, but has not been shown to improve ADHD itself.

Adult trials are few, but poor sleep makes attention worse for anyone, so it is worth checking first.

• Hiscock et al., BMJ (sleep trial, 244 children) (2015)

A few small trials suggest children who are low in iron (ferritin) or zinc may improve when the shortfall is corrected, but results are inconsistent. There is no good evidence that topping up someone with normal levels helps, and too much iron is harmful.

Ask your doctor for a test rather than guessing.

• Systematic review of iron and zinc in ADHD (2021)

Meta-analyses in children and teens find small-to-moderate gains in symptoms and thinking skills. The best-run trials show smaller effects, and adult studies are few.

It is good for mood and sleep, so it is a sensible add-on, not a replacement for treatment.

• ADHD Evidence: summary of recent exercise meta-analyses (2025)

Mindfulness programmes show small benefits in trials. In adults they looked good when clinicians rated them but not when patients rated themselves.

Many people enjoy it and it is low risk, but the evidence is not strong enough to single it out.

• Zhang et al., meta-analysis of meditation-based therapies (2023)
• Ostinelli, Cortese et al., Lancet Psychiatry (113 trials in adults) (2025)

In the 2025 adult review, tDCS beat control only when clinicians rated it, not when patients did. One home-based adult trial was positive for inattention; trials in teenagers were mostly negative.

Treat it as research, not treatment.

• Ostinelli, Cortese et al., Lancet Psychiatry (113 trials in adults) (2025)
• Leffa et al., JAMA Psychiatry (home-based tDCS in adults) (2022)

The studies so far are few and mostly small, often with college students and without strong comparison groups. A larger structured campus programme (ACCESS) helped, but it was built on CBT rather than coaching alone.

A good coach may well help you; there just is not the proof to say coaching in general works.

• ACCESS trial for college students with ADHD

Working alongside another person (in the room or online) is one of the most talked-about ADHD tricks. As of 2026 the research is a 12-person virtual reality study, a student poster and a thesis, with mixed results.

It is plausible, cheap and harmless, so try it if it helps you. Our free focus room is one way.

• Body doubling in VR, preprint (12 people) (2025)

Strict "few foods" diets show large effects in parent ratings, but those trials are small and parents know what their child is eating. Removing artificial colours shows a small effect, and studies disagree on whether it holds up when teachers or observers rate it.

A small group of children may react to specific foods; this needs a dietitian, not guesswork.

• Stevenson, Sonuga-Barke et al., J Child Psychol Psychiatry (2014)

A handful of small trials suggest a possible small add-on effect, but they are not good enough to rely on. If you are low in vitamin D for other reasons, treat that.

High-dose supplements can cause harm, so check with a doctor first.

• Shen et al., vitamin interventions in ADHD and autism: meta-analysis (2025)
• Talib et al., Can J Psychiatry: diet and supplements in childhood mental disorders (2024)

Small trials in Iran reported saffron doing about as well as a low dose of methylphenidate. Nobody else has repeated those results, so it is too early to trust them.

• Han et al., Phytotherapy Research: review of saffron in ADHD (2024)

The FDA-cleared game improved children’s results on an attention test, but did not clearly improve what parents saw at home in the main trial. The maker was sold in 2024 for about $34 million.

• Kollins et al., Lancet Digital Health (STARS-ADHD trial, 348 children) (2020)
• MobiHealthNews on the Akili sale (2024)

The Cochrane review, the most careful kind of summary, found little evidence that omega-3 or omega-6 supplements improve ADHD symptoms in children and teens. It is widely sold for ADHD anyway.

• Gillies et al., Cochrane review (2023)

Across 20 trials and 1,214 people, neurofeedback showed essentially no effect when the people rating it didn’t know who had the real thing. Trials using standard protocols showed a small effect, not enough to justify the cost: it is often sold as a course costing thousands of dollars.

• Westwood et al., JAMA Psychiatry (20 trials) (2025)

The device was cleared in 2019 on a study of 62 children. A later trial of 150 children with a sham (fake) device found it safe but no better than the sham on symptoms, attention, mood or sleep.

• Conti et al., Nature Medicine (King's College London) (2026)

Seven small children’s trials, taken together, showed no clear benefit over placebo. Plenty of adults with ADHD use coffee to get going, and that is fine, but it is not a treatment, and it can make sleep worse.

• Perrotte et al., Brain Sciences (2023)

In blinded studies where neither parent nor child knew who had sugar, there was no effect on behaviour. Cutting sugar is fine for general health; it will not change ADHD.

• Wolraich et al., JAMA: sugar and behaviour, meta-analysis of blinded studies (1995)