Abstract
Background:
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. Conventional treatments include behavioral therapy and medications such as methylphenidate and atomoxetine. However, Complementary and Alternative Medicine (CAM) is increasingly being explored, particularly in settings where access to standard treatment is limited. This case report presents the use of an alternative supplement in managing ADHD symptoms.

Aim:
To report symptom reduction in a 7-year-old boy with ADHD treated using an alternative supplement.

Materials and Methods:
A 7-year-old pupil presented with a three-year history of restlessness, inattention, and poor academic performance. Diagnosis of ADHD was made using the DSM-5 criteria. Symptom severity was assessed using the Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS) and Teacher Rating Scale (VADTRS). Due to high cost and unavailability of standard medication, the child was commenced on a syrup supplement. The major constituent of the syrup is Bacopa monnieri, which has both cholinergic and antioxidant effects. Other constituents of the syrup include sweeteners such as Celastrus paniculatus and Convolvulus pluricaulis, which have some anxiolytic and antioxidant properties. Patient was given 5 mls twice (30 mg) daily and was monitored monthly over a six-month period.

Results:
Baseline DSM-5 symptom count was 10/18, with predominant hyperactive/impulsive features. VADPRS scores were 4/9 (inattentive) and 6/9 (hyperactive/impulsive). VADTRS showed 5/9 (inattentive) and 6/9 (hyperactive/impulsive) in the respective domains. After six months of treatment, the DSM-5 score reduced to 2/18, reflecting an 80% improvement. VADPRS and VADTRS scores dropped to 1/9 in both domains, with significant reduction in symptoms. Academic performance remained below average, but classroom behavior improved notably.

Conclusion:
This case suggests that an alternative supplement may contribute to symptom reduction in ADHD, especially in low-resource settings. Further studies are needed to evaluate its safety and effectiveness on a broader scale

Key words: Attention Deficit Hyperactivity Disorder (ADHD); Complementary and Alternative Medicine (CAM); Bacopa monnieri; Herbal treatment for ADHD; Phytotherapy; Child mental health.