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The Effect of Combined Iron and Methylphenidate Use in Iron Deficient Attention deficit Hyperactivity Disorder (ADHD)

D Saha1, U K Sarkar, J Parvin

  • 1Dr Dipa Saha, Associate Professor, Pediatric Neurology, Addin Women's Medical College Hospital (AWMCH), Dhaka, Bangladesh;

Mymensingh Medical Journal : MMJ
|March 31, 2026
PubMed

Insights

Combining methylphenidate with iron is more effective for treating severe ADHD in children with iron deficiency anemia than methylphenidate alone. This approach leads to faster symptom improvement and better outcomes.

Area of Science:

  • Pediatric Neurology
  • Clinical Psychology
  • Hematology

Background:

  • Iron deficiency anemia (IDA) is linked to attention deficit hyperactivity disorder (ADHD) and can affect treatment outcomes.
  • Iron's role as both a risk factor and a psychostimulant modulator in ADHD warrants further investigation.

Purpose of the Study:

  • To compare the efficacy of methylphenidate combined with iron versus methylphenidate alone in children with severe ADHD and IDA.
  • To evaluate the impact of iron supplementation on ADHD symptom severity in this population.

Main Methods:

  • A randomized controlled trial involving 50 children with severe ADHD and iron deficiency.
  • Participants were assigned to receive either methylphenidate plus iron (Group A) or methylphenidate alone (Group B) for three months.
  • Evaluations included Conner's rating scale, complete blood count (CBC), and serum ferritin levels at baseline, one month, and three months.

Main Results:

  • All hematological parameters, including serum ferritin, showed improvement from baseline in both groups.
  • Increased ferritin concentration correlated with decreased ADHD index T-scores at one month (p=0.047) and three months (p=0.026).
  • The combined methylphenidate and iron group (Group A) demonstrated a faster treatment response (13.39±6.90 days) compared to the methylphenidate alone group (Group B) (18.48±8.69 days).

Conclusions:

  • Combined therapy of methylphenidate and iron is more effective than methylphenidate alone for treating children with ADHD and iron deficiency.
  • Iron supplementation plays a crucial role in improving ADHD symptoms in deficient children.
  • Early intervention with iron alongside psychostimulants can accelerate treatment response in pediatric ADHD with IDA.

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