Efficiency of Different Supplements in Alleviating Symptoms of ADHD with or Without the Use of Stimulants: A Systematic Review

Objective: This review aims to assess the efficacy and safety of different supplements, such as L-theanine, caffeine, Ginkgo biloba L., and Bacopa monnieri for improving ADHD symptoms, to determine the most effective supplement and provide insight for medical practice. Methods: International databases (PubMed/MEDLINE and Scopus) were searched for English-language RCTs, open-label studies, and cross-sectional studies. Results: Studies on L-theanine, caffeine, Ginkgo biloba L., and Bacopa monnieri have shown various effects on ADHD symptoms. L-theanine improved sleep efficiency but not other sleep parameters. Caffeine showed no significant benefits, although its combination with L-theanine may enhance attention. Bacopa monnieri consistently improved inattention, hyperactivity, and memory, whereas Ginkgo biloba L. reduced ADHD symptoms, particularly inattention, but was less effective than methylphenidate. Conclusions: The evidence revealed the potential use of supplements as complementary ADHD treatments under clinical guidance. The limited effect of supplements cannot replace the well-documented efficacy of stimulants for ADHD treatment. Additional studies are needed to ascertain the most effective dosages and the safety of these supplements as adjunctive treatments for ADHD.