Is Fish Oil Good for ADHD?

Note: The U.S. Food and Drug Administration (FDA) does not approve supplements for safety or effectiveness. Talk to a healthcare professional about whether a supplement is the right fit for your individual health, and about any potential drug interactions or safety concerns.

Still, psychiatrists say the jury’s still out when it comes to whether fish oil can really help ADHD. They also warn not to use fish oil to replace current ADHD treatments. If you want to try fish oil supplements for yourself or your child, talk to a doctor first to make sure you’re taking an appropriate dose that won’t interfere with any medications.

When it comes to fish oil and ADHD, there have been a number of research investigations — and even more claims unsupported by science.

What the Science Says About the Benefits of Fish Oil for ADHD

But scientists aren’t convinced that omega 3s can make a notable difference for people with ADHD.

“In clinical trials with humans, supplementing with combined DHA/EPA for at least three months has improved attention and cognitive performance in youth with ADHD, but the results were modest at best,” says Ashvin Sood, MD, a psychiatrist with Washington Interventional Psychiatry in Washington, DC.

“In ADHD studies, the beneficial effects of fish oil supplements tend to be small, and the evidence is not as strong as for stimulant medications or behavioral therapy,” says Rachel V.F. Rohaidy, MD, a psychiatrist at Baptist Health Miami Neuroscience Institute in Florida.

Debunked Fish Oil Claims

Many popular claims about the benefits of fish oil for ADHD are not backed by science.

‘Fish Oil Cures ADHD’

“This is simply false,” says Sood. “The effect of omega-3s is mild and cannot compete against treatments like Ritalin.”

Studies comparing the effectiveness of fish oil with ADHD stimulant medications like Ritalin (methylphenidate) or Adderall (amphetamine and dextroamphetamine) have found that fish oil had a much smaller effect, says Dr. Rohaidy.

‘Fish Oil Alone Can Treat ADHD’

Adding omega-3s to your treatment plan may help, but they should never replace standard care, says Markus Ploesser, MD, a psychiatrist and integrative medicine physician at Open Mind Health. This is especially true for people with moderate to severe ADHD, he notes.

‘Every Child With ADHD Should Take Fish Oil’

“Some children benefit, especially those with low baseline omega-3 levels, but it’s not universally effective,” says Dr. Ploesser.

‘Fish Oil Pills Are Just as Good as Eating Fish’

“A common myth is that taking fish oil pills is just as effective as eating omega-3-rich fish,” says Sood. “In reality, whole foods seem to confer broader benefits.”

“Whole-food sources of omega-3s provide additional nutrients and may be better absorbed,” adds Ploesser.

Still, high-quality supplements can be beneficial and can raise omega-3 levels, “particularly if one doesn’t eat fish,” says Sood.

‘All Omega-3 Supplements Are the Same’

Not all fish oil supplements are the same. “The EPA-to-DHA ratio matters,” says Rohaidy. “Some evidence suggests that a higher EPA ratio may be more beneficial for ADHD symptoms.”

Sood says that “Some cheaper brands might contain lower concentrations or impurities. A myth is assuming any omega-3 pill will do. In truth, high-purity, high-EPA/DHA products are preferable — and some include antioxidant vitamin E to prevent spoilage.”

Yes, fish oil is considered safe to try in general within the recommended doses. “Omega-3s are well tolerated,” says Ploesser.

High doses of fish oil, however, can cause:

• Gastrointestinal issues such as diarrhea, nausea, loose stools, an upset stomach, or heartburn
• A fishy aftertaste, or “fish burps,” which can be reduced with enteric-coated capsules
• A higher risk of bleeding, which is why people on blood thinners need to be extra careful, Ploesser says

There are currently no official guidelines on the recommended amount of fish oil to take for ADHD. But Ploesser recommends the following dosage, on the basis of existing research:

• Adults: 1,000–2,000 milligrams (mg) of combined EPA/DHA daily
• Children: Often 500–1,000 mg daily, but dosing should be discussed with a doctor

Note that EPA-heavy formulations seem to be most effective, such as a ratio of 750 mg EPA to 250 mg DHA.

Sood advises that people look for an EPA:DHA ratio of at least 3:1 for ADHD. “For example, if aiming for 1,000 mg total, you might use 800 mg EPA plus 200 mg DHA,” he says.

“In practice, choosing a product labeled ’high EPA’ or ’EPA concentrate’ aligns with what the research shows,” he adds.

Dietary Sources

If you or your child are living with ADHD and you’d like to try fish oil, it’s a good idea to include foods rich in omega-3s in your diet. “Dietary sources, as part of a balanced diet, are generally more beneficial than supplements,” says Sood.

• Salmon
• Mackerel
• Tuna
• Herring
• Sardines

Supplements

“Major medical organizations generally regard up to 3 grams (g) per day of combined EPA/DHA as safe for adults,” says Sood. “Most studies in children have used around 500 to 1,200 mg of combined EPA/DHA per day.”

It's important to remember that there isn’t any definitive evidence that fish oil helps ADHD, says Rohaidy. And if there are any benefits, they will take weeks to months to appear.

“Studies suggest it may take 8 to 12 weeks before noticeable cognitive or behavioral improvements occur,” Rohaidy says.

“In practice, parents and individuals report subtle changes starting after about 1 month, with clearer improvements by three months,” Sood says. This is longer than stimulant medications which can work in a matter of days, he adds, but those medications can also have more significant side effects.

“Comprehensive ADHD treatment including behavioral therapy, coaching, and medication is more effective than just taking supplements,” says Rohaidy.

The best approach is to work with a specialist who can create a personalized treatment plan.

In addition to fish oil, there are other supplements that have the potential to help ADHD symptoms, especially if there is a deficiency:

• Zinc
• Iron
• Magnesium
• Vitamin D

Please note that the data on the potential effectiveness of the above supplements is limited and of poor quality, so speak to a healthcare professional before beginning any new regimen.

“In general, parents should seek psychiatric care for ADHD for their child when there are issues in two settings: the home and the school,” Sood says.

“Symptoms that often catch our attention include hyperactivity or disruptive behavior leading to school suspensions, severe distractibility outside of the use of screens, and impulsive decision-making that leads to physical injury.”

“We also have to assess if there are any other learning disorders as well. Initially, access to a pediatrician is the first line of treatment, who will then refer to a child psychiatrist. Pediatricians and child psychiatrists alike spend a lot of time gathering data and verifying which medication may be right for the child. We add medications slowly and check in with patients frequently to ensure safety,” Sood says.

Other doctors who can help diagnose ADHD include:

• Clinical psychologists or neuropsychologists, who can offer comprehensive tests for ADHD and therapy, but who cannot prescribe medication
• Psychiatrists, who are best for medication management, especially in adults
• Neurologists
• Child and adolescent psychiatrists or child and adolescent neurologists
• Primary care physicians, who can diagnose or manage mild cases

• There is some modest evidence that fish oil offers some benefits for ADHD, but the jury’s still out on whether it improves symptoms at all.
• Fish oil is generally considered safe to try within recommended doses unless there’s an allergy issue.
• If you do decide to try fish oil for ADHD symptoms, don’t use it to replace conventional ADHD treatment. Speak to a healthcare professional before taking any supplements.