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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, Jerusalem, Israel.
The Journal of Pediatrics
|April 1, 1997
Summary
Methylphenidate is safe and effective for children with epilepsy and ADHD who are seizure-free. Caution is advised for those 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 compared methylphenidate and placebo, alongside antiepileptic drugs (AEDs).
- Assessments included neurologic exams, IQ tests, behavioral checklists, electroencephalography (EEG), and the continuous-performance task (CPT).
Main Results:
- Methylphenidate did not increase seizures in seizure-free children; 2 of 5 children with ongoing seizures showed no change or a reduction.
- No significant changes in AED levels or EEG findings were observed.
- Parental reports indicated benefit in 70% of children, with enhanced performance on the CPT. Side effects were mild and transient.
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.