Saffron: a remedy for improving concentration and cognition in ADHD
Attention Deficit Hyperactivity Disorder (ADHD)
ADHD is a neuro-developmental disorder that causes hyperactivity, impulsive behaviour, and attention problems. ADHD interferes with a person’s ability to exercise age-appropriate control of their behaviour and/or their cognition.
It's estimated one in 20 children in Australia have ADHD and it is 10 times more common in boys than girls. Three types of ADHD are now recognised: predominantly inattentive type, predominantly hyperactive-impulsive type and combined type.
Common signs and symptoms of ADHD include:
Inattention – difficulty concentrating, forgetting instructions, moving from one task to another without completion
Impulsivity – talking over the top of others, losing control of emotions easily, being accident-prone, acting without thinking
Overactivity – constant fidgeting and restlessness
While many children will face some of the difficulties that fall within under symptoms of ADHD, there is a marked difference between a young child misbehaving and a young child with ADHD. Children with ADHD will experience these difficulties in two or more settings (for example at home and school), will have presented with the symptoms before 7 years of age and their symptoms result in significant impairment in everyday functioning.
As symptoms of ADHD can overlap with numerous other behaviour and medical conditions, diagnosing ADHD isn’t straight forward. There is no specific test for ADHD so the assessment of a child is made using a wide range of information provided by both the family, a child’s school and clinical observations by doctors, paediatricians and child psychologists.
While there is no cure, positive parenting strategies, school support, dietary interventions, counselling can significantly help many children with ADHD. Some children may also be prescribed stimulant medications or in some cases anti-depressants for additional support. However, about 30% of patients do not respond to stimulant medications or cannot tolerate their side effects. Therefore in addition to pharmaceutical interventions, more research is now being done on nutritional therapeutics and their potential to address some of the key pathophysiological aspects of ADHD, without producing unmanageable side effects. One particular therapeutic that has recently been researched is Saffron.
Saffron is the world’s most expensive spice and was traditionally used in ancient medicine for its antispasmodic, antiseptic, antidepressant, anticancer, and anticonvulsant effects. Saffron is the reddish-orange dried stigmas of the purple crocus flower. Each flower only has three stigmas (threads) and they must be harvested by hand before being set our to dry under the sun. It takes thousands of stigmas to make a small amount of saffron, which is why saffron is such a prized spice.
Saffron has been extensively studied and research has found saffron to have several beneficial health effects. The therapeutic potential of saffron is based on its potent antioxidant capacity, ability to regulate neurotransmitters function, improve synapse transmission and support cognitive ability.
Researchers have started to investigate saffron as evidence has shown that saffron counteracts many of the same biochemical and molecular abnormalities that are associated with ADHD, such as oxidative stress and dysregulated neurotransmitter systems, particularly the dopamine and norepinephrine pathways.
As antidepressants are used and have been reported to be effective in improving ADHD symptoms for some patients, it was hypothesised that saffron may also be beneficial in ADHD as saffron has been shown to exert potential antidepressant activities by influencing neurotransmitter pathways in several clinical trials and experimental models. Also, evidence has shown saffron can be beneficial in disorders involving memory and learning disorders, such as Alzheimer's, which further supports the potential benefits of use in ADHD.
Saffron Treatment in ADHD
The study covered in this research brief was a randomised, double-blind study that compared the safety and efficacy of saffron versus the most commonly prescribed pharmaceutical for ADHD, methylphenidate (also known as Ritalin) in improving symptoms of children with ADHD.
The trial observed 50 people over 6 weeks, checking in at 3 and 6 weeks for symptom assessment using the Teacher and Parent Attention-Deficit/Hyperactivity Disorder Rating Scale-IV. The participants were split into two groups of 25, with one group receiving 20-30mg of saffron per day and the other receiving 20-30mg of methylphenidate. Each participant's exact dose was determined by their weight.
The study found both interventions resulted in improvements in the Teacher and Parent rating score, with saffron shown to be just as effective as methylphenidate. Additionally, the adverse effects noticed in the trial were slightly lower in the saffron group than in the methylphenidate group.
Adverse Reactions and Safety
In terms of safety, no serious adverse event was observed in any of the patients and all noticed adverse effects were mild to moderate and tolerable. The side effects that were reported were headaches, a dry mouth, nausea, insomnia, decreased appetite, sweating and vomiting.
For the side effects there were experienced, there was not a significant difference and they were low in both groups. The saffron group reported less of these side effects, with only 2 patients in the group experiencing each of the side effects, in comparison to 2-5 people in the methylphenidate group.
This study found that the short-term therapy of saffron had the same efficacy compared with methylphenidate in children with ADHD. The clinical relevance of these findings was emphasized by improvements seen in both Parent and Teacher Rating Scale scores. Additionally, the study also found saffron to be a safe treatment option for ADHD, with equal or lesser adverse effects than methylphenidate.
The apparent improvements in patients symptoms and level of safety strongly suggest that further investigation of saffron in ADHD is both valuable and promising, especially given the already known cognitive and antidepressant benefits. To continue exploring the potential benefits, future larger placebo-controlled studies with longer treatment periods would be beneficial in helping to gain a deeper understanding of saffron as a treatment option for ADHD.
It is important to remember that although saffron is a naturally occurring compound in food that is easily accessible, the supplementation or use of it as a therapeutic intervention still needs to be discussed and approved by your child’s physician or health care practitioner.
Albrecht, B., Uebel-von Sandersleben, H., Gevensleben, H., & Rothenberger, A. (2015). Pathophysiology of ADHD and associated problems-starting points for NF interventions?. Frontiers in human neuroscience, 9, 359. doi:10.3389/fnhum.2015.00359
Baziar, S., Aqamolaei, A., Khadem, E., Mortazavi, S. H., Naderi, S., Sahebolzamani, E., … Akhondzadeh, S. (2019). Crocus sativus L. Versus Methylphenidate in Treatment of Children with Attention-Deficit/Hyperactivity Disorder: A Randomized, Double-Blind Pilot Study. Journal of Child and Adolescent Psychopharmacology, 29(3), 205-212. doi:10.1089/cap.2018.0146
Dunn, G., Nigg, J., & Sullivan, E. (2019). Neuroinflammation as a risk factor for attention deficit hyperactivity disorder. Pharmacology Biochemistry And Behavior, 182, 22-34. doi: 10.1016/j.pbb.2019.05.005