철분 결핍이 있는 주의력결핍 과잉행동장애(ADHD) 소아에서 메틸페니데이트(리탈린)에 철분을 병용하면 치료 반응이 더 빠르고 효과도 뛰어나다는 무작위 대조 시험 결과가 발표됐다.
방글라데시 다카의 신경과학연구소(NINS) 소아신경과 외래에서 진행된 이번 연구는 철결핍성 빈혈(IDA)을 동반한 중증 ADHD 소아 50명을 메틸페니데이트+철분 병용군(A군, 25명)과 메틸페니데이트 단독군(B군, 25명)에 무작위 배정해 3개월간 추적했다.
1개월, 3개월 시점의 코너스 평가 척도, 전혈구 검사, 혈청 페리틴을 평가했다. 두 군 모두 모든 혈액학적 지표와 혈청 페리틴이 기저치 대비 개선됐다. 페리틴 농도가 증가할수록 ADHD 지수 T점수가 1개월(p=0.047) 및 3개월(p=0.026) 시점에서 유의하게 감소했다.
치료 반응 시점은 A군이 평균 13.39±6.90일, B군이 18.48±8.69일로, 철분 병용군에서 약 5일 빠른 것으로 나타났다.
연구팀은 "철결핍성 ADHD 소아 치료에서 메틸페니데이트와 철분 병용 치료가 메틸페니데이트 단독 치료보다 더 효과적"이라고 결론지었다.
> 건강 팁: ADHD 진단을 받은 아이에게 철분 결핍이 동반돼 있는지 확인하는 것이 중요하다. 철분 수치가 낮다면 의사와 상의해 식이 개선(붉은 육류, 시금치, 두부, 콩류)이나 철분 보충을 통해 신경 기능 지원에 도움을 줄 수 있다.
📖 *Combined Iron and Methylphenidate in Iron-Deficient ADHD Children* |
PubMedChildren with iron deficiency anemia and severe ADHD respond faster to treatment and show greater symptom reduction when iron supplementation is added to standard methylphenidate therapy, according to a randomized controlled trial conducted in Bangladesh and published in the *Mymensingh Medical Journal*.
Iron plays a critical biological role in dopaminergic neurotransmission — the same pathway targeted by methylphenidate (Ritalin) and other ADHD medications. Iron deficiency has been linked to ADHD symptoms, and restoring iron levels may enhance the efficacy of psychostimulant treatment.
Fifty children with severe ADHD and iron deficiency anemia, seen at the pediatric neurology outpatient department of the National Institute of Neurosciences and Hospital (NINS) in Dhaka, were randomized to either Group A (methylphenidate plus iron supplementation, n = 25) or Group B (methylphenidate alone, n = 25) for three months.
Outcomes were assessed using Conner's Rating Scale for ADHD severity, complete blood count, and serum ferritin at one and three months. Both groups showed improvements in all hematological parameters and ferritin levels from baseline. Notably, as ferritin concentration increased, ADHD index T-scores decreased significantly at both one month (p = 0.047) and three months (p = 0.026) — directly linking iron repletion to behavioral improvement.
Treatment response (defined as a clinically meaningful reduction in ADHD severity) was achieved an average of 13.39 ± 6.90 days into treatment in the combination group, versus 18.48 ± 8.69 days in the methylphenidate-only group — a clinically meaningful difference of approximately five days.
The authors concluded that combined methylphenidate and iron therapy is more effective than methylphenidate alone for iron-deficient children with ADHD, and recommended routine iron status assessment in this population.
> Health tip: All children diagnosed with ADHD should have iron status checked, as iron deficiency may be a contributing or complicating factor. Iron-rich foods — lean red meat, lentils, tofu, spinach, and fortified cereals — can help support dopaminergic function alongside medical treatment, but supplementation should be guided by a doctor.
📖 *Combined Iron and Methylphenidate in Iron-Deficient ADHD Children* |
PubMed