Adjunctive Citicoline, Phosphatidylserine or Their Combination Added to Standard Pharmacotherapy in Children and Adolescents with ADHD in Turkey: A Multicenter Retrospective Study
27th World Congress of IACAPAP, Hamburg, Almanya, 1 - 04 Temmuz 2026, ss.725-726, (Özet Bildiri)
- Yayın Türü: Bildiri / Özet Bildiri
- Basıldığı Şehir: Hamburg
- Basıldığı Ülke: Almanya
- Sayfa Sayıları: ss.725-726
- Dokuz Eylül Üniversitesi Adresli: Evet
Özet
Objective: Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition characterized by developmentally inappropriate and impairing inattention, hyperactivity, and impulsivity. Stimulants and non-stimulants are commonly used in managing ADHD symptoms. However, some patients may have suboptimal responses to these medications and may benefit from adjunctive phosphatidylserine (PS) and/or citicoline (CC).To the best of our knowledge, most available studies on these agents have been conducted in Western countries, and data from Turkish patients are lacking.The aim of this multicenter retrospective study was to evaluate whether the addition of citicoline, phosphatidylserine, or their combination as adjunctive treatments to core pharmacological agents used in the management of ADHD, such as methylphenidate, atomoxetine, and guanfacine, was associated with an incremental clinical benefit. Methods: A total of 236 children with ADHD (64.0% male; 64.3% with comorbidities) from 11 study centers across Turkey were included. Citicoline and/or phosphatidylserine were prescribed exclusively as adjunctive agents to established ADHD medications and were not used as monotherapy in any patient. All comorbidities were allowed. Clinicians evaluated symptom severity using the Clinical Global Impressions (CGI) scale at baseline and at the sixth month, while parents reported ADHD and disruptive behavior symptoms. Descriptive, bivariate, and multivariate analyses were performed. Statistical significance was set at p < 0.05 (two-tailed). Results: The most commonly used adjunctive treatment was combined citicoline and phosphatidylserine (n = 138, 58.5%), followed by citicoline alone (n = 81, 34.3%) and phosphatidylserine alone (n = 17, 7.2%). These adjunctive agents were most frequently combined with methylphenidate (n = 176, 74.6%), followed by guanfacine (n = 84, 35.6%) and atomoxetine (n = 79, 33.5%). Median baseline scores for CGI-Severity, inattention, hyperactivity/impulsivity, oppositionality, and conduct disorder symptoms were 4.0 (IQR = 2.0), 6.0 (IQR = 3.0), 4.0 (IQR = 5.0), 2.0 (IQR = 5.0), and 0.0 (IQR = 1.8), respectively. At the sixth month, corresponding scores decreased to 3.0 (IQR = 2.0), 3.0 (IQR = 4.0), 2.0 (IQR = 3.8), 1.0 (IQR = 2.8), and 0.0 (IQR = 0.0), respectively. Discussion: Citicoline, phosphatidylserine, and their combination do not appear to have an independent therapeutic role in ADHD but may provide additional clinical benefit when used as adjunctive treatments to standard pharmacotherapy, with a favorable tolerability profile. Further prospective, controlled studies are required to confirm these findings and to better define their role in the treatment of ADHD.