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Epilepsy and attention deficit hyperactivity disorder: is methylphenidate safe and effective?
V Gross-Tsur1, O Manor, J van der Meere
1Pediatric Neurobehavioral Unit, Shaare Zedek Medical Center and Braun School of Public Health and Community Medicine, Hadassah-Hebrew University, Jerusalem, Israel.
The Journal of Pediatrics
|January 1, 1997
Summary
Methylphenidate is safe and effective for children with epilepsy and attention deficit hyperactivity disorder (ADHD) who are seizure-free. Caution is advised for children still experiencing seizures during treatment.
Area of Science:
- Pediatric Neurology
- Child Psychiatry
Background:
- Epilepsy and attention deficit hyperactivity disorder (ADHD) frequently co-occur in children.
- Managing ADHD symptoms in children with epilepsy requires careful consideration of treatment safety and efficacy.
Purpose of the Study:
- To evaluate the safety and effectiveness of methylphenidate in children diagnosed with both epilepsy and ADHD.
- To assess the impact of methylphenidate on seizure control, behavior, and cognitive function in this pediatric population.
Main Methods:
- A 4-month study involving 30 children (aged 6.4-16.4 years) with epilepsy and ADHD.
- A double-blind, crossover design comparing methylphenidate to placebo, alongside antiepileptic drugs (AEDs).
- Assessments included neurological exams, EEG, IQ tests, Childhood Behavior Checklist, and the Continuous Performance Task (CPT).
Main Results:
- Methylphenidate did not increase seizures in seizure-free children; 2 of 5 children with ongoing seizures experienced increased attacks.
- No significant changes were observed in AED levels or EEG findings.
- Methylphenidate improved ADHD symptoms in 70% of children and enhanced CPT performance, with mild, transient side effects.
Conclusions:
- Methylphenidate is a safe and effective treatment option for children with epilepsy and ADHD who are seizure-free.
- Careful monitoring and consideration are necessary for children with epilepsy who continue to experience seizures while on AED therapy and methylphenidate.