Efficacy of homeopathy in Attention Deficit Hyperactive Disorder

Dr Neha Khan

ABSTRACT:
Attention deficit hyperactive disorder (ADHD) is the common neurodevelopment disorder, among the most chronic health conditions affecting school-aged children, and the most seen mental disorder in children. ADHD includes the symptoms like inattention, increased distractibility and difficulty sustaining attention during tasks or activities, poor impulse control, decreased self-inhibitory capacity, hyperactivity and motor restlessness. This article deals with the overview of ADHD and its homeopathic approach.

KEY WORDS: ADHD, inattention, hyperactivity, Homeopathy, Psora.

ABBREVIATIONS:
ADHD – attention deficit hyperactive disorder; DAT 1 – dopamine active transporter; DRD 4 -dopamine responsive dystonia; DTG- dopamine transporter gene; DSM-diagnostic and statistical manual of mental disorders

INTRODUCTION
Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder in children. It is characterized by persistent inattention, difficulty in controlling behavior and hyperactivity causing impairment of learning and social functioning. Children will be failing to pay close attention to details,¹ when spoken to directly, appearing not to listen ,failing to follow instructions or finish the given work, having difficulty in sustaining attention during tasks or play, and organizing activities ,avoiding or disliking the school activities that require sustained mental effort (e.g: homework’s) , easily gets distracted, and experiencing frequent forgetfulness in daily activities.¹

RISK FACTORS:-

• Maternal smoking, alcohol consumption
• Abnormality dopamine transporter gene (DTG) and thyroid receptor beta gene
• Mutations of DAT1, DRD4 genes
• Lead, mercury exposure
• Traumatic brain injury, abnormalities in cerebellum³

Diagnosis of children up to the age of 16 years requires the presence of at least 6 symptoms of inattention or 6 symptoms of hyperactivity-impulsivity for at least 6 months in two or more environments.²

DSM-5 CRITERIA:-

• Persistent inattention/ hyperactivity, impulsivity that interferes with functioning or development ∙
• symptoms persists for at least 6 months
• symptoms present in two or more settings (home ,school)
• must begin before 12 years of age
• symptoms interfere with social, academic or occupational functioning
• symptoms must not be secondary to another disorder^2,9

Classification:
There are three kinds (presentations) of ADHD based on the symptoms¹ 1. Predominantly hyperactive-impulsive: Most symptoms (6 or more) are in the hyperactivity-impulsivity categories, and less than 6 symptoms of inattention are present..¹

• Fidgets with or taps hands or feet, or squirms in
• Not able to stay seated (in classroom )²
• Runs about or climbs where it is ²
• Unable to play or do leisure activities ²
• Always “on the go,” as if driven by a ²
• Talks too ²
• Blurts out an answer before a question has been finished (for instance may finish people’s sentences, can’t wait to speak in conversations).²
• Has difficulty waiting for his or her turn, such as while waiting in ²

2. Predominately inattentive: The majority of symptoms (6 or more) are in the inattention category and less than 6 symptoms of hyperactivity-impulsivity may still be present to some degree. Parents or teachers may not readily recognize these children as having a problem.¹

• Doesn’t pay close attention to details or makes careless mistakes in school or job tasks.² ∙ Does not follow through on instructions and doesn’t complete schoolwork, chores or job duties (may start tasks but quickly loses focus).²
• Has problems organizing tasks and work (for instance, does not manage time well; has messy, disorganized work; misses deadlines).²
• Avoids or dislikes tasks that require sustained mental effort, such as preparing reports and completing ²
• Often loses things needed for tasks or daily life, such as school papers, books. ²

3. Combined hyperactive-impulsive and inattentive: These children have six or more symptoms each of inattention and hyperactivity-impulsivity. Most children have the combined type of ADHD. ¹

HOMOEOPATHIC APPROACH:
Homoeopathy has great scope in the treating ADHD. Homoeopathy is a psychosomatic medicine. Homeopathy plays a major role in giving importance to mental expression, disposition, maintainace and development of the disease.

Organon of medicine (6th edition, § 211) ― This state holds good to such an extent, that the disposition of the patient often chiefly determines the selection of the homoeopathic remedy, as being decidedly characteristic symptom which can least of all remain concealed from the accurately observing physician. This pre-eminent importance of the emotional state holds good to such an extent that the patient‘s emotional state often tips the scale in the selection of homoeopathic remedy. This is a decidedly peculiar sign which among all the signs of disease, can least remain hidden from the exactly observing physician.

A detailed case history (Aphorism-218) about the health of the child and the family, the pregnancy and delivery, early development, vaccinations, life events, schooling, favorite foods, drinks to mention just a few points. The more information gathered, the easier it is to find that the remedy. Being fundamental cause of mental disease is psoric miasm, so patient should be subjected to a radical anti psoric treatment (Aphorism-227).⁷

REPERTORIAL APPROACH:

 SYNTHESIS REPERTORY RUBRICS

• Mind, concentration
• Mind, restlessness, children,
• Mind, anger, children
• Mind, gestures, makes- strange attitudes and

RADAR REPERTORY RUBRICS

1. Mind – antisocial
2. Mind –kleptomania
3. Mind- destructiveness ,children in
4. Mind –behavioral problems children in
5. Mind – rudeness children in
6. Mind – impulse morbid rash

KENT REPERTORY

1. Restlessness: , Arg-n., Ars., Bell., Calc., Hyos., Lyco., Merc., Puls., Sep., Sili., Stram., Sulph., Tarent.,
2. Violent, vehement: , Bell., Cic., Hyos., Nux-v., Stram.
3. Mischievous:
4. Hurry: Nat-m., , Tarent., Stram.
5. Destructiveness: , Hyos., Stram., Tarent., Vert.
6. Anger, irascibility: , Anac., Bry., Cham., Hepar., Ign., Kali-c., Kali-s., Lyc., Nat-m., Nit-ac., Nux-v., Petr., Sep., Staph., Sulph.
7. Conscientious about triffle: , Sil.
8. Contradict disposition to: Hep
9. Contradiction intolerant of: , Ign., Nat-m.
10. Obstinate: , Arg-n., Bell., Calc., Cham., Nux-v., Tarent.
11. Quarrelsome: , Ign., Nux-v., Sulph., Tarent.

MURPHY REPERTORY

1. Children, anxious
2. Children, autistic children
3. Children, concentration difficult studying
4. Children, Hyperactive
5. Children,
6. Children, quieted child
7. Children, restless

HOMOEOPATHIC THERAPEUTICS:

HALOGEN GROUP OF MEDICINES ⁵

Acidum fluoricum:
Uncommon buoyancy of mind: fears nothing and is self satisfied. Disposition to be exceedingly anxious, causing perspiration. Forgetfulness of dates

Natrum muriaticum:
Disposition to weep easily, but consolation from others aggravates. During sleep, many fears and anxieties surface up, leading to sleeplessness, night mares, and dreams. Aggressive behavior in children due to lack of love. Extreme sensitivity. Projected anger in the form of irritability, impulsiveness and impetuousness. Child’s emotional trauma is expressed by delusion that he looked wretched when he sees his face in the mirror. Difficulty in calculations. Mild and sentimental children.

Baryta muriaticum
Great anxiety, environment and surroundings; strange; everything is strange, anger (see irritability and quarrelsome), irritability, Impaired thinking; difficulty concentrating, Confusion

Arsenicum iodatum
Irritability, Unable to study, difficult in concentration.

Iodium
Lachrymose disposition and mental dejection. Melancholy, Hypochondriasis, sadness, anxiety. Fear, Anxious apprehensions. Restless agitation (with inclination to move about), which will neither permit the patient to remain seated, nor to sleep. Irresistible impulse to run.

Kalium bromatum:
Nervous restlessness. Cannot sit still, must move around or keep occupied. Night terrors in children who see horrible visions awake shrieking and recognizing no one. The child constantly imagines that he is singled out as an object of divine wrath. Answers in mono syllable. Sometimes for all questions ‘no’ is the only answer. Anxiety at night especially in dentition age group. Fidgetiness constantly plays with fingers and hands. Omits or reverses words when talking and writing.

Radium bromatum
Apprehensive, depression, hardly able to move about. Fear of being alone; of the dark; wants to have someone near. Irritable, cross, easily vexed. Mind cloudy and unable to think clearly, stupidity.

Stramonium:
Loquacious, talks all the time, sings, make verses and raves, nonstop talk. The mania more acute, Disposed to talk continually, incessant and incoherent talking and language, praying beseeching, entreating⁴. Desire light and company cannot bear to be alone, worse in dark and solitude cannot walk in a dark room. Rapid changes from joy to sadness.⁶

Arsenic album:
Melancholic, indifferent, anxious, fearful, restless, full of anguish, irritable, sensitive, Mentally restless but physically too weak to move, cannot rest in any place, changing places continually, Wants to be moved for one bed to another, great prostration, cannot bear the smell or sight of food, great thirst for cold water, drinks often but little at a time.⁶

Chamomilla:
Child exceedingly irritable, fretful, quiet only when carried, impatient, wants this or that and become angry when refused or when offered, petulantly rejects, peevish, cannot return a civil answer. ⁶

Veratrum album
Aimless, wandering from home. Mania, with desire to cut and tear things. Poprophagia, violent mania alternates with silence and refuses to talk. Sullen indifference. It reduces the potential for temper tantrums in children who struggle to control their emotions.⁵

Hyoscyamus Niger
Mania of quarrelsome and obscene character inclined to be unseemly and immodest in acts, gestures and expressions. Very talkative. Foolish. Suspicious. Inclined to laugh at everything⁵

Coffea cruda
Very emotional, affections from sudden surprises, especially joyful surprises, great sleeplessness unusual activities of mind and body .Full of ideas, quick to act, lively fancies.¹⁰

References

1. O. P. Ghai Essential Pediatrics. Delhi: CBS publisher & Distributors Pvt Ltd. 8th edition.
2. Fifth edition text revision DSM 5- TR , American psychiatric association
3. Pediatrics for medical graduates ,Arun babu thirunavukkarasu
4. Text Book of Materia Dr. S. K. Dubey.
5. Boericke, W, and Oscar E Pocket Manuel of Homeopathic Materia Medica. 1st edition. New Delhi: Indian Books & Periodicals Publishers, 2004
6. Allen H.C. Keynotes & Characteristics with comparisons of some of the leading remedies of Materia Medica. New Delhi: Indian Books & Periodicals publishers, 10th edition.
7. Organon of medicine 6^th edition Samuel Hahnemann, translated by William Boericke, MD
8. The Dictionary of practical material medicine by JH
9. Nelson Textbook of pediatrics 21st Edition
10. Leaders in Homeopathic therapeutic with grouping and classification by B Nash 11. Repertory of material medica by J.T. Kent
11. Homoeopathic Medial Repertory a Modern Alphabetical and Practical Repertory by Robin Murphy 3^rd revised edition

Dr.Neha Khan
PG Scholar, Department of Organon of Medicine and Homoeopathic philosophy
UGO Dr.Manisha   DKMM Homoeopathic Medical college,Chh.Sambhaji Nagar