Clin Psychopharmacol Neurosci 2021; 19(4): 712-720
Effects of Iron Supplementation on Attention Deficit Hyperactivity Disorder in Children Treated with Methylphenidate
Sepehr Tohidi1,*, Elham Bidabadi2,*, Mohammad-Javad Khosousi3, Melika Amoukhteh2, Maryam Kousha4, Parham Mashouf5, Tamkin Shahraki2
1Student Research Committee, School of Medicine, Guilan Universtiy of Medical Sciences, 2Pediatric Diseases Research Center, Guilan University of Medical Sciences, 3Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, 4Department of Psychiatry, Shafa Hospital, Guilan University of Medical Sciences, 5Emergency Department, Arya Hospital, Rasht, Iran
Correspondence to: Elham Bidabadi
Pediatric Diseases Research Center, Guilan University of Medical Sciences, Namjoo Street, Siadati Avenue, Rasht, Iran
*These authors contributed equally to this study.
Received: November 4, 2020; Revised: January 7, 2021; Accepted: June 27, 2021; Published online: November 30, 2021.
© The Korean College of Neuropsychopharmacology. All rights reserved.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: To evaluate the effect of iron on the attention deficit hyperactivity disorder, treated with methylphenidate.
Methods: This double-blind, randomized placebo-controlled clinical trial was performed on 50 children with attention deficit hyperactivity disorder under the treatment of methylphenidate, with ferritin levels below 30 ng/ml and absence of anemia. They were randomly assigned into two groups of ferrous sulfate and placebo, for 12 weeks. Conners' Parent Rating Scale (CPRS) was used to assess the outcome in the first, sixth, and twelfth weeks.
Results: Almost all CPRS subscales improved in the ferrous sulfate group from the baseline to the endpoint, although only the changes in conduct subscale scores were significant (p = 0.003). There was no significant difference in score changes between two groups in intergroup comparison. Also, the score of learning problems (p = 0.007) in the first six weeks, and conduct (p = 0.023) and psychosomatic (p = 0.018) subscales in the second six weeks were improved in the ferrous sulfate group compared with the placebo group.
Conclusion: Our study showed promising effects of iron supplementation in the improvement of subscales of the CPRS.
Keywords: Attention deficit disorder with hyperactivity; Iron; Child; Methylphenidate

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