Oxidative and nitrosative stress in ADHD: possible causes and the potential of antioxidant-targeted therapies

Attention deficit hyperactivity disorder (ADHD) has a complex aetiology although theories associated with disturbances in dopaminergic and noradrenergic activity are most commonly cited. The importance of these catecholamines in ADHD is supported by its effective treatment utilising stimulant and non-stimulant medications that modify their activity. Recently, there has been interest in oxidative and nitrosative stress (O&NS) in ADHD and its potential to contribute to this condition. In this article, research investigating O&NS in ADHD is reviewed and its impact on catecholaminergic activity and neurological structure is discussed. Lifestyle, environmental, psychological and nutritional influences on O&NS in people with ADHD are reviewed, and evidence for the therapeutic efficacy of antioxidant-related therapies is assessed. A selection of interventions with antioxidant mechanisms is presented as potential options for the treatment of ADHD. However, further research is required to help elucidate the role of O&NS and antioxidants for the prevention and management of ADHD.