Randomised Controlled Clinical Study to Evaluate the Efficacy of Abheerumuladi Ghrita in Children with Attention Deficit Hyperactivity Disorder

Child development refers to the sequence of physical, cognitive, emotional and social changes that occurs  from birth till the conclusion of adolescence.Cognitive skills allow children to understand the relationships between ideas, to grasp the process of cause and effect and to improve their analytical skills. Neurodevelopment is a part of cognitive development and neurodevelopmental dysfunctions reflect disruptions of neuroanatomic structure or psychophysiologic functions and may be associated with academic under achievement, behavioural difficulties and problems with social adjustment. Attention Deficit Hyperactivity Disorder (ADHD) is one of the common neurobehavioural disorder and  one of the most prevalent chronic health conditions affecting school aged children. It is mainly characterised by inattention, hyperactivity and impulsivity among children, adolescents and even in adults.  The prevalence of ADHD among children and adolescents in India (2009-2019) ranges from  7.6%–15%. The prevalence is more in male children (9.40%) than female children(5.20%). The peak prevalence in males is observed in the age group of 8-15 years and in females from 7.6 – 15 years. Children with ADHD have poor social interactions, thus they have poor relationships with parents, siblings and teachers. They are also poor in academics, thus, resulting in poor self esteem, peer rejection, inability to evaluate self and have negative emotions. The abnormal behaviour of the child is a major cause of concern for the parents as it affects their social status. This may eventually lead to psychological stress in parents and has serious implication on the quality of life of the family members.  Children with behavioural disorders are incredibly vulnerable to rejection and anger and they deserve to grow up in a safe environment, with warm acceptance from the society. Thus, interventions are required to tackle down this serious social burden. Currently psychosocial and behavioural therapies are widely adopted in the management of ADHD and to control the symptoms of ADHD psychostimulant drugs are being used rarely. The psychostimulant drugs used, increase the release and inhibit the reuptake of dopamine, thus enhancing attention span, concentration, and reducing impulsivity. They have no role in enhancing the academic performance of the child, but have severe adverse effects like sleep disturbances, irritability, growth suppression, adverse cardiovascular events like sudden cardiac death, and myocardial infarction.   ADHD can be considered under ‘Unmada’ spectrum of disorders in Ayurveda. The features like Cheshta Vibhrama(unsteadiness in activities), Ä€chara Vibhrama (perversion of conducts), Smriti Vibhrama (perversion of memory) and Bhakti Vibhrama (perversion of interest) of Unmada are predominantly observed in ADHD.   Ayurveda aims at correcting these Vibhramas by correcting the functions of Buddhi and Manas through various measures. One such time tested measure is administration of “Medhya Yogasâ€, which sharpens the cognitive skills of the child. Though several Medhya Yogas are mentioned in Ayurveda, only a handful of them have been evaluated in the treatment of ADHD, a disease which has multiple deficits.   Abheerumuladi Ghrita is one such formulation mentioned in Unmada Chikitsa which aims at correcting the Chestadi Vibhramas through its Medhya properties.   Hence, the Present study is an effort to evaluate the efficacy of Abheerumuladi Ghritha in children with Attention Deficit Hyperactivity Disorder.