The effect of phosphatidylserine on behavioral problems in children with attention deficit hyperactivity disorder

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children, characterized by attention deficit, hyperactivity, and various internalizing and externalizing behavioral problems. Phosphatidylserine (PS), a nutritional supplement, has shown potential in improving behavioral symptoms. This study aimed to evaluate the effects of PS on core symptoms and associated behavioral problems in children with ADHD. We conducted a randomized, open-label, controlled trial involving 56 children with ADHD. Participants were randomly allocated to receive either phosphatidylserine or atomoxetine for three months. Core symptoms as well as internalizing and externalizing behaviors were assessed using the SNAP-IV rating scale and the Achenbach Child Behavior Checklist (CBCL). The PS group showed no significant improvement in core ADHD symptoms (attention deficit: M = 0.26, SD = 0.60, p > 0.05, d = 0.43; hyperactivity/impulsivity: M = 0.11, SD = 0.46, p > 0.05, d = 0.23; total score: M = 3.82, SD = 10.27, p > 0.05, d = 0.37), whereas the atomoxetine group showed significant improvements in attention deficit (M = 0.40, SD = 0.50, p < 0.05, d = 0.80), hyperactivity/impulsivity (M = 0.26, SD = 0.49, p < 0.05, d = 0.54), and total scores (M = 7.00, SD = 9.38, p < 0.05, d = 0.75). In contrast, the PS group demonstrated significant reductions in internalizing (M = 1.83, SD = 3.28, p < 0.05, d = 0.56) and externalizing behaviors (M = 3.38, SD = 5.20, p < 0.05, d = 0.65), whereas the atomoxetine group improved only in externalizing behaviors (M = 2.54, SD = 5.42, p < 0.05, d = 0.47). Further analysis revealed that both groups showed significant decreases in aggressive behaviors (PS: M = 2.79, SD = 4.24, p < 0.05, d = 0.66; atomoxetine: M = 2.43, SD = 4.90, p < 0.05, d = 0.50). Phosphatidylserine was not associated with significant improvements in core ADHD symptoms but was associated with reductions in internalizing and externalizing behavioral problems, particularly in reducing aggression. These findings suggest that PS warrants further investigation as a promising adjunctive treatment targeting behavioral dysregulation in children with ADHD.