Behavior abnormalities and poor school performance due to oral theophylline use

Area of Science:

• Pediatric Pulmonology
• Behavioral Pediatrics
• Clinical Pharmacology

Background:

• Previous studies linked oral theophylline to adverse effects on learning and behavior in children with asthma.
• Differentiating drug effects from asthma symptoms is crucial for accurate assessment.

Purpose of the Study:

• To evaluate the specific impact of oral theophylline on the behavior and academic performance of children with asthma.
• To distinguish theophylline's effects from those of the underlying asthma condition.

Main Methods:

• A double-blind, placebo-controlled study involving 20 asthmatic children (6-12 years) who had not used oral bronchodilators for 6 months.
• A 4-week treatment period with either theophylline (serum levels 10-20 µg/mL) or placebo, preceded by a 2-week baseline.
• Monitoring of home and school behavior/performance by parents and teachers, supplemented by psychologic testing.

Main Results:

• Seven out of 20 children on theophylline showed changes in school behavior or performance compared to baseline.
• None of the children receiving placebo exhibited similar changes (P = .004).

Conclusions:

• Short-term oral theophylline administration can adversely affect school performance and behavior in asymptomatic asthmatic children.
• Caution is advised when prescribing theophylline to this age group; close monitoring or alternative treatments are recommended.