Case study Australian Journal of Herbal and Naturopathic Medicine 2024 36(2)

The homeopathic treatment of concentration

issues associated with attention deficit
hyperactivity disorder in adults: a case report

Lauren Lee BHSc (Naturopathy), BCom (Accounting)

Suite 1 Level 12/187 Macquarie St Sydney NSW 2000
Contact information
Lauren Lee
Email beyondhealth.laurenlee@gmail.com

Keywords ADHD, concentration issues, case report, homeopathy, complementary medicine

For referencing Lee L. The homeopathic treatment of concentration issues associated with attention deficit hyperactivity
disorder in adults: a case report. The Australian Journal of Herbal and Naturopathic Medicine 2024;36(2):88-95.
DOI https://doi.org/10.33235/ajhnm.36.2.88-95
Submitted 14 June 2023, accepted 12 February

Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterised by inattention and/or
hyperactivity-impulsivity, lasting for at least six months, and resulting in impaired social, academic, and occupational functioning.
This case report concerns a 30-year-old female with ADHD-related concentration issues. The Boenninghausen Generalities
Method and polarity analysis were used to categorise symptoms, followed by differentiation of medicines to determine the
most indicated remedy, Phosphorus 200C.

Introduction clinical interviews assess for co-morbid conditions,

Attention Deficit Hyperactivity Disorder (ADHD) is a such as insomnia, and are used for monitoring treatment
neurodevelopmental disorder affecting approximately progress.4 The aetiology of ADHD is diverse and includes:
a million Australian adults.1 It is characterised by genetics; environmental factors, such as foetal exposure
inattention and/or hyperactivity-impulsivity, lasting for at to stress and intrapersonal violence; and neurobiological
least six months, and results in impaired social, academic factors, such as abnormal levels of catecholamines in the
and occupational functioning.2 Diagnosis is based on a brain.5 Conventional treatment consists of medications,
combination of: clinical assessment including use of the psychotherapy and psychoeducation, or a combination of
Diagnostic and Statistical Manual of Mental Disorders treatments.5 There are three main classes of medications:
Fifth Edition (DSM-5) or the International Classification stimulants, which mimic the action of norepinephrine and
of Diseases 11th Revision (ICD-11) classifications, dopamine; non-stimulants, which selectively inhibit the
rating scales, and clinical interviews.3 The DSM-5 and reuptake of norepinephrine; and antidepressants, which
ICD-11 classifications are similar, and are summarised increase catecholamines in the brain by blocking their
as: 5+ symptoms in adults, 17+ years old; persisting for at reabsorption.5 Both short and long term improvements
least six months; present before 12 years old; noticeable in ADHD symptoms have been observed in adults.6
in two or more settings; negatively impacting social, Although evidence regarding side effects and the safety of
academic, or work functioning; and not better explained medication are contradictory and inconclusive,7 concerns
by another mental disorder.4 Symptoms are then are mounting about cardiovascular side effects in adults,
grouped under three presentation types: predominantly increased suicidal tendencies, psychotic symptoms, and
inattentive; predominantly hyperactive-impulsive; or physical and/or psychological dependence.8 Accordingly,
combined.4 Inattentive symptoms applicable to this complementary and alternative medicine modalities, such
case study patient include: difficulty maintaining as homeopathy, are increasingly sought after as treatment
attention, inability to follow instructions, forgetfulness that is natural, holistic, and individualised.4
in daily activities, inability to listen, and difficulty
Methods
organising tasks and activities. Hyperactivity-impulsivity
symptoms are not experienced by this patient and thus Homeopathy principles
a combined presentation is unlikely. Rating scales and Homeopathic treatment for this case was based on three

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Case study Australian Journal of Herbal and Naturopathic Medicine 2024 36(2)

key principles of homeopathy: The Law of Similars, and thus, research regarding adults is limited. See
meaning remedy selection is based on a substance that Appendix 2 for a summary. For the purposes of this
would create similar symptoms in the presenting patient review, research pertaining to children and adolescents
as it would in a healthy individual; The Law of Simplicity, will be included.
one remedy is selected and prescribed at any one time; A recent meta-analysis of four double-blind, placebo-
and The Law of Minimum Dose, posology is based on controlled trials of individualised homeopathy (e.g.
the least quantity of remedy required to affect change by stramonium, tuberculinum and calcarea carbonica)
stimulating the patient’s inherent healing ability.9 against placebo and two pragmatic studies comparing
Individualised treatment is key in homeopathy meaning homeopathy against standard care (behavioural therapy
that no two patients with the same medical condition are and methylphenidate) found homeopathic treatment to
prescribed the same remedy.10 Consideration is given to have clinically relevant and statistically robust effect
the patient’s ‘totality of symptoms’, which is explained compared to placebo and other comparators in improving
below, and their mental, emotional, and physical ADHD in children.15 However, as the sample size was
symptoms.9 small (30–83 participants), and study duration was short,
further analysis of long-term studies is required.
Boenninghausen Generalities Method
These findings are consistent with the previous systematic
Case taking and subsequent remedy selection was based
review and meta-analysis of 22 randomised controlled
upon the Boenninghausen Methodology, which looks at
trials (RCTs) of individualised homeopathic treatment
the totality of symptoms including: location, sensation,
which found that medicines prescribed in individualised
modalities, concomitants, and causation.9 Specifically,
homeopathy may have a small but statistically significant
the Boenninghausen’s Generalities Method was used for
treatment effect.16 However, the overall quality of
selection of the most suitable remedy, which emphasises
evidence was low, so new RCTs of high quality are
sensation and modalities as Boenninghausen discovered
required to improve the totality of reliable evidence.
that both are not confined to a particular symptom but
are applicable to symptoms of the case thus, forming the Notably, PA improves the gathering of evidence by
basis of the individual as a whole.11 enabling more precise matches between patient symptoms
and homeopathic treatment. PA was first used in a Swiss
Polarity analysis (PA) ADHD double-blind trial and was responsible for the
PA was used as a tool to increase the reliability and precision successful outcome that highly diluted homeopathic
of the selected homeopathic remedy. PA is a development remedies had a significant beneficial effect on impulsivity,
of Boenninghausen’s Concept of Contraindications.12 PA inattention, and hyperactivity.12
deals with polar symptoms, symptoms that can have an
Since then, PA has been further refined and tested in other
opposite aspect, and their varying intensity and grades
fields, including a prospective study of 50 patients with
to determine the polarity difference, which is a plus/
multimorbidities, including concurrent sleep issues. The
minus for each specific symptom.12 A higher polarity
study found that PA is effective in cases of multimorbidity
difference indicates a more suitable remedy that matches
and homeopathy is able to take over a significant part of
the characteristic symptoms of the patient, provided there
treatment of multimorbid patients at a lower cost than
are no contraindications. Whereas, a negative polarity
conventional medicine.17
difference indicates a less suitable remedy that has
little chance of effectively treating the chief complaint Case presentation
of the patient.13 The methodology involves use of:
physical modalities, as they are most reliable; at least Onset was from 5-6 years of age, and it may have been
five polar symptoms; characteristic symptoms during the emotionally triggered, following physical abuse (being
ailment, that are not traits present when the patient is in hit by her mother and teachers) and sexual assault in her
good health; and mental symptoms for differentiation mid-20’s.
purposes.13 In cases of ADHD, determination of the The patient is a 30-year-old female Doctor of Philosophy
homeopathic remedy is performed with the help of the student presenting with daily concentration issues.
Checklist for Perception Disorders. See Appendix 1 for Sensations of this temporal lobe problem, as confirmed by
the completed checklist.14
brain wave testing, include: anxious feelings in her body,
Literature review agitation, socially debilitating uncontrollable laughter
when uncomfortable, forgetfulness mid-sentence, and
There has been an increasing body of research into
the safety and efficacy of homeopathy as a non- choking pain in her throat; all which occur daily and
pharmacological alternative for ADHD given concerns worsen in the evening. Onset was from 5–6 years of age,
regarding the short and long term effects of medications, and it may have been emotionally triggered, following
such as Ritalin. Research has found homeopathic physical abuse (being hit by her mother and teachers).
treatment to have clinically relevant and statistically Concomitant symptoms include: bilateral dull throbbing
significant short-term effect in the treatment of ADHD upper shoulder pain, violent vivid dreams, pungent
however, further research is required to determine the perspiration, and frequent urination. Concentration
long-term benefits efficacy of homeopathic treatment.15 improves with: sweet and fatty foods, vomiting to “help
16
Given the onset of ADHD occurs in childhood, the get more food in”, and sleeping. Conversely, exercise and
majority of research pertains to children and adolescents rumination regarding self-worth worsens concentration.

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Discussion
Categorisation of symptoms
Table 1. Totality of symptoms and polar symptoms,

Chief complaint: Concentration issues, self-reported diagnosis of ADHD based on clinical psychologist’s assessment
of DSM-5.
Location Temples (i.e. temporal lobe located beneath temples of brain)
Sensation • Anxious feeling in body (i.e. butterflies in stomach)
• Choking pain (i.e. choked up in throat when uncomfortable)
• Irritable (i.e. agitated)
• Ill humour (i.e. uncontrollable laughter when uncomfortable/upset)
• Inattentiveness (i.e. forgetfulness mid-sentence)
Modalities • < physical exertion
• << thinking of it (i.e. rumination/mental effort)
• > after vomiting
• >> after sleep
• >> food (i.e. carbohydrate foods like bread)
Concomitants • Frequent urination
o Location: urinary tract
o Sensation: every half hour, or hour
o Modality: < water, > urination
• Shoulder pain
o Location: upper shoulder joint
o Sensation: dull throbbing
o Modality: < intense concentration (eyes strained, reading), > muscle relaxation
• Vivid dreams
o Location: limbic system
o Sensation: violent (e.g. alien attack, tower crash)
o Modality:, < stress, > security & safety (housing)
• Pungent perspiration
o Location: armpits
o Sensation: smelly
o Modality: < stress, > deodorant & movement

Symptoms are selected with emphasis on sensation and modalities, as these symptoms, particularly the polar symptoms,
form the basis of the patient as a whole and indicate a more suitable remedy that matches the characteristic symptoms of
the patient, provided there are no contraindications.13

Rubrics
Firstly, modalities - circumstances and conditions that worsen or improve a complaint, are considered with aggravations
noted first, then ameliorations.18

Figure 1. Modalities

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Case study Australian Journal of Herbal and Naturopathic Medicine 2024 36(2)

Secondly, sensations - perceived experiences of a complaint, are considered, noting that 3 are mental sensations and
ranked last. There are no polar symptoms so the non-polar symptoms are:

Figure 2. Sensations

Physical generals - specific parts of the body and/or organs, including location are considered, this is non-polar.

Figure 3. Physical generals, location

Thirdly, concomitants - secondary complaints that occur during or around the same time as the main complaint, are
considered with polar symptoms noted first.18

Figure 4. Concomitants, polar.

Then concomitants that are non-polar are considered.

Figure 5. Concomitants, non-polar.

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Lastly, mentals - perceived experiences of a complaint pertaining to the mind or process of thinking, are considered for
reference and differentiation, with polar symptoms noted first.18

Figure 6. Mentals, polar

Then mentals that are non-polar are considered.

Figure 7. Mentals, non-polar

Repertorisation
Before PA, the repertorial matrix indicated remedies in order of suitability according to the individual’s presenting symptoms with
Pulsatilla listed first, reflecting 11 of the 15 symptoms and a total score of 29, followed by Nux-Vomica listed second, reflecting
10 of the 15 symptoms and a total score of 28. With modalities and sensations prioritised, symptoms 1 to 7, Nux-Vomica would be
more suitable with a total score of 15 versus Pulsatilla with a total score of 13 however, further examination of the remedy’s specific
indications and individual’s overall presentation is required following PA to determine the preferred remedy.

Figure 8. Repertorial Matrix, before PA.

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Case study Australian Journal of Herbal and Naturopathic Medicine 2024 36(2)

After PA, the repertorial matrix was updated to a more reliable and precise list indicating remedies in order of their sum
of symptoms as well as their polarity difference. With the latter prioritised, Natrium Carbonicum and Baryta carbonica
are considered the most suitable remedies both with a polarity difference of 9, followed by Phosphorus and Coffea cruda
which both have a polarity difference of 7. Notably with PA, Pulsatilla is then considered the least suitable remedy as 5
of the 7 polar symptoms are weighted strongly in opposition and therefore contraindicated. Further examination of the
remedies with a higher polarity difference provided a means for prescription differentiation.

Figure 9. Repertorial Matrix, after PA

Prescription differentiation at night, improves with warm food, and who vomits
Following examination of the remedies with a higher undigested food several hours after eating.21 Accordingly,
polarity difference, 4 remedies were selected and three of the patient’s symptoms were addressed with
differentiated for the purposes of this case. the later symptoms being questionable given the lack
specificity given the patient improves with fatty foods
Phosphorus which can be cold, and vomits soon after eating.
Phosphorus is indicated for individuals who experience: Nux vomica (nux-v.)
difficulty concentrating, desire for ice-cream and
chocolate, increased appetite especially at night, and Nux vomica is indicated for individuals who experience:
vomit undigested food soon after eating.19 Accordingly, irritability, desire for fatty foods, vomiting that worsens
three of the patient’s symptoms were addressed, with the when frustrated, falls asleep just before wake up time,
later symptom being questionable as the patient improved wakes unrefreshed, and is sleepy during the day.19
only after vomiting rather than non-stop; however, Accordingly, five of the patient’s symptoms were
addressed with the last three pertaining to the patient’s
phosphous, was most closely indicated to the patient as
secondary complaint, and the specificity of vomiting
nux vomica and kreosotum are indicated respectively
being questionable as the patient’s vomiting does not
when vomiting respectively occurs with vexation and as
worsen but rather improves her chief symptoms.
a result of weak digestion.15
Coffea cruda Posology
Coffea cruda is indicated for individuals who experience: Given the depth of this case spans over 30 years
agitation, increased appetite and excessive eating, and and involves a combination of symptoms that are
improvement with sleep.20 Accordingly, three of the characteristic, physical, emotional, and mental, a higher
patient’s symptoms were addressed. Notably, vomiting potency was required and thus, 200C of an oral form
was not indicated and while symptoms relating to the of Phosphorus was selected and prescribed for four
patient’s secondary complaint were addressed (a racing weeks until the patient’s follow-up consultation.9 No
mind, sleeplessness at night, and sleepiness all day), contraindications were observed. This posology was
phosphorus was preferred as it addressed a characteristic evident in a recent case assessment whereby 200C was
and polar symptom.19 given as a single dose to an individual with behavioural
issues spanning seven years; however, a more indicated
Kreosotum remedy of ammonium muriaticum was prescribed.22
Kreosotum is indicated for individuals who experience: Similarly, 200C was given as a single daily dose over
restlessness that is aggravated during the evening and the period of a year and improvements were observed

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in performance, mental functioning, and memory.23 treatment of attention deficit hyperactivity disorder in children
Re-assessment is recommended at four weeks to monitor and adolescents: A systematic review with network meta-analyses
of randomised trials. PLOS ONE 2017;12(7).
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5. Pellow J, Solomon EM, Barnard CN. 2011. Complementary and
development and alleviation of ADHD symptoms; dietary
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intervention to regulate glycemic load and thus, glucose Hyperactivity Disorder (ADHD). Alternative Medicine Review.
uptake into cells including the brain; herbal treatment, 2011;16(4):323–337
such as Rhodiola rosea which enhances the transport of 6. Cortese S, Adamo N., Del Giovane C, Mohr-Jensen C, Hayes
serotonin precursors into the brain, and thus, serotonin AJ, Carucci S, et al. Comparative efficacy and tolerability
levels; and supplementary intervention of nutrients, such of medications for attention-deficit hyperactivity disorder in
children, adolescents, and adults: A systematic review and
as essential fatty acids which reduce attention difficulties
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Disorder medication on behavioural and neuropsychiatric
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abuse psychologist to help reduce the ongoing impact using linked prescription databases. Biological Psychiatry. 2019;
of her experience of sexual abuse, serum creatinine 86(5):335–343.
to asses kidney function in case of urinary toxic metal 8. Sinha A, Lewis O, Kumar R, Yeruva SL, Curry BH. Adult ADHD
provocation, and urinary kryptopyrroles to address zinc, medications and their cardiovascular implications. Case Reports
B6, and omega-3 fatty acid deficiency.24 in Cardiology. 2016;2343691.
9. Owen D. Principles and practice of homeopathy: The therapeutic
Conclusion and healing process. London, UK: Churchill Livingstone; 2007.
10. Reichenberg-Ullman J, Ullman R, Ritalin free kids: Safe and
This case illustrates the individualised prescription of a effective homeopathic medicine for ADHD and other behavioral
homeopathic treatment inclusive of an individual’s total and learning problems. Roseville, CA: Prima Health; 2013.
signs and symptoms. The Boenninghausen Generalities 11. Homeobook: A Critical Study on Boenninghausen’s therapeutic
Model and Polarity Analysis, placed polar modalities pocket book. [Internet]. 2012. Available from: https://www.
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therapeutic-pocket-book/
matrix could not be relied upon alone as differentiation
12. Frei H, Everts R, von Ammon K, Kaufmann F, Walther D, Hsu-
of the materia medica is further required to determine
Schmitz, S F. et al. Homeopathic treatment of children with
the most indicated remedy, and the remedy’s ever- attention deficit hyperactivity disorder: A randomised, double
changing alignment to the individual’s evolving signs blind, placebo controlled crossover trial. European Journal of
and symptoms. Pediatrics. 2005;164(12):758–67.
13. Homeobook. Polarity analysis: A path to precise prescription
Homeopathic treatment is highly individualised in homoeopathy. [Internet] 2019. Available from: https://
according to the patient’s totality of symptoms and www.homeobook.com/polarity-analysis-a-path-to-precise-
chosen methodology. In this case, the Boenninghausen prescription-in-homoeopathy/
Generalities Method and polarity analysis placed polar 14. Frei, H. ADD/ADHD. [Internet] 2014. Available from: http://
modalities and sensation at the forefront. Of note for www.heinerfrei.ch/add-adhd
15. Gaertner, K., Teut, M. & Walach, H. 2022. Is homeopathy
developing practitioners, is that the resulting repertorial
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matrix cannot be relied upon as differentiation of analysis. Pediatric Research. 2022. doi: 10.1038/s41390-022-
the materia medica is required to determine the most 02127-3. Retracted article.
indicated remedy, and the remedy is ever-changing based 16. Mathie RT, Lloyd SM, Legg, LA, Clausen J, Moss,S.,
on the patient’s evolving symptoms. Davidson, JRT, Ford I. Randomised placebo-controlled trials of
individualised homeopathic treatment: Systematic review and
Conflict of interest meta-analysis. Systematic Reviews. 2014; 3(142).
17. Frei H. 2015. Homeopathic treatment of multimorbid patients: A
The authors declare no conflicts of interest.
prospective outcome study with polarity analysis. Homeopathy.
2015; 104(1):57–65.
Funding
18. Moharana SS. Analysis and evaluation of symptoms for
The authors received no funding for this study. repertorisation. [Internet] 2012. Available from: https://
www.homeobook.com/analysis-evaluation-of-symptoms-for-
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Saint-Gerons et al. The pharmacological and non-pharmacological remedies for the future of Homoeopathy. Watkins Media Ltd

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21. Schroyens F. Core synthesis [Computer software]. Archibel S. A.

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