Overcoming Adherence Barriers in Adult ADHD: A Narrative Review of Cumulative Vitamin D Supplementation Strategies
DOI:
https://doi.org/10.12775/JEHS.2026.93.72539Keywords
Attention Deficit Hyperactivity Disorder, Adult ADHD, Medication Adherence, Vitamin D Deficiency, Executive DysfunctionAbstract
Background. Vitamin D is an essential neurosteroid affecting the central nervous system and dopaminergic pathways. Adults with attention-deficit/hyperactivity disorder (ADHD) are particularly susceptible to its deficiency. Adherence to daily supplementation can be a major challenge for them. ADHD-specific executive dysfunction and memory deficits make daily routines demanding, often causing treatment discontinuation. This untreated deficiency exacerbates core symptoms of the disorder.
Aim. This narrative review provides a rationale for using cumulative, infrequent vitamin D dosing to reduce memory reliance and improve adherence among adults with ADHD.
Materials and methods. We searched the PubMed, Scopus, and Google Scholar databases. Data from guidelines, meta-analyses, reviews, randomized controlled trials (RCTs), and qualitative research on neurobiology, pharmacokinetics, safety, and behavioral sciences were synthesized regarding therapeutic adherence.
Results. Adults with ADHD exhibit high rates of daily medication non-adherence due to their cognitive profile. Intermittent cumulative dosing (e.g., 10,000 IU weekly or 30,000 IU monthly) is as effective as daily dosing in maintaining optimal 25-hydroxyvitamin D [25(OH)D] levels. Large trials show that monthly boluses (up to 100,000 IU) are safe and do not increase the risk of hypercalcemia. Nearly 78% of patients prefer infrequent dosing, facilitating behavioral strategies like habit anchoring by reducing memory demands.
Conclusion. Replacing daily supplementation with a cumulative regimen bypasses ADHD-specific cognitive barriers. Integrating infrequent dosing with behavioral techniques improves long-term adherence. Future RCTs are needed to develop tailored clinical guidelines.
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Copyright (c) 2026 Joanna Żukowska, Agata Chrobak, Ewa Kacynel, Wiktoria Myślicka, Lizaveta Zhukava, Darya Volkava, Volha Sakovich, Kai-Chiun Weng, Kateryna Bessmylna, Alesia Kravets
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