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Methylphenidate in children with seizures and attention-deficit disorder
H Feldman1, P Crumrine, B L Handen
1Department of Pediatrics, Children's Hospital, Pittsburgh, Pa 15213.
Insights
Methylphenidate showed safety and efficacy in children with seizures and attention-deficit disorder (ADHD). The treatment improved ADHD symptoms without increasing seizures or affecting antiepileptic drug levels.
Area of Science:
- Pediatric Neurology
- Child Psychiatry
- Clinical Pharmacology
Background:
- Attention-deficit disorder (ADHD) is common in children with epilepsy.
- Managing ADHD in this population requires careful consideration of psychostimulant safety.
- Methylphenidate is a commonly prescribed medication for ADHD.
Purpose of the Study:
- To assess the safety and efficacy of methylphenidate in children with both epilepsy and ADHD.
- To evaluate the impact of methylphenidate on seizure activity and electroencephalogram (EEG) findings.
- To determine the effect on antiepileptic drug (AED) levels.
Main Methods:
- A double-blind, placebo-controlled crossover study.
- Ten children (aged 6-10 years) with epilepsy and ADHD, stabilized on a single AED, participated.
- Methylphenidate hydrochloride was administered at 0.3 mg/kg twice daily on school days.
Main Results:
- Statistically significant improvements were observed in ADHD symptoms using the Conners' Teacher Rating Scale and Finger Tapping Task.
- Trends toward improvement were noted on the Matching Familiar Figures Test and Discriminant Reaction Time.
- No seizures occurred during the study, and EEG showed no significant changes in epileptiform activity or background patterns. Antiepileptic drug levels remained stable.
Conclusions:
- Methylphenidate appears to be a safe and effective treatment option for children with concurrent seizures and ADHD.
- The study suggests that methylphenidate does not exacerbate epilepsy or interfere with AED efficacy in this specific pediatric population.
- Further research is warranted to confirm these findings in larger cohorts.
Abstract:
This study assessed the safety and efficacy of methylphenidate in children with seizures and attention-deficit disorder. Ten children, aged 6 years 10 months to 10 years 10 months, without seizures while receiving a single antiepileptic drug, were evaluated in a double-blind medication-placebo crossover study with methylphenidate hydrochloride was administered at 0.3 mg/kg per dose and given at 8 AM and 12 PM on school days only. The use of methylphenidate was associated with statistically significant improvements on the Conners' Teacher Rating Scale and on the Finger Tapping Task and with trends toward improvement on the Matching Familiar Figures Test and Discriminant Reaction Time tests. No child had seizures during the study period nor subsequently for those who continued receiving psychostimulants. There were no significant changes of epileptiform features or back-ground activity on electroencephalograms and no alterations in antiepileptic drug levels. Methylphenidate may be a safe and effective treatment for certain children with seizures and concurrent attention-deficit disorder.