Attention-deficit/hyperactivity disorder medication and seizures

Abstract

Results reaffirm that patients with ADHD are at higher risk of seizures. However, ADHD medication was associated with lower risk of seizures within individuals while they were dispensed medication, which is not consistent with the hypothesis that ADHD medication increases risk of seizures.

Medication treatment for attention‐deficit/hyperactivity disorder and the risk of acute seizures in individuals with epilepsy

“…Our results provide converging evidence with a number of previous studies, but not all, 19 using varying research designs [10][11][12][13][14][15]24 and showing limited support for the hypotheses that ADHD medication in prescribed doses is associated with an increased risk of acute seizures. In addition, we were able to expand the previous literature by studying the risk across varying definitions of seizure history and epilepsy, and by including persons with a wide range of NDDs in addition to ADHD, including autism, intellectual disabilities, and tic disorders.…”

“…Results from the analyses of repeated ADHD medication periods replicate findings from a recent large-scale US study 24 and one small clinical study 15 showing reduced rates of seizures associated with ADHD medication periods, even after adjusting for concurrent AED treatment. Convergent results across countries with different health care systems and ADHD medication prescription practices (United States and Sweden), and across different types of data sources indicate that this effect is unlikely to be merely a methodologic artifact.…”

“…Some of these concerns were addressed in a recent large US health care claims study, using a within‐individual design to compare the risk of seizures during ADHD medication and nonmedication periods for the same person. Results suggested that ADHD medication periods were associated with a reduced risk of seizure in patients with and without seizure history . Although well powered, the study was not without limitations; commercial health care claims databases are not population representative, information on treatment and seizure history was limited, and comorbid neurodevelopment disorders (NDDs) were not considered.…”

“…Results suggested that ADHD medication periods were associated with a reduced risk of seizure in patients with and without seizure history. 24 Although well powered, the study was not without limitations; commercial health care claims databases are not population representative, information on treatment and seizure history was limited, and comorbid neurodevelopment disorders (NDDs) were not considered. Polypharmacy may be of particular concern in individuals with NDD multimorbidity, stressing the need to evaluate ADHD medication safety in this patient group.…”

Practical Considerations for the Assessment and Treatment of ADHD in Children with Epilepsy

“…Current data suggests that patients with epilepsy can be treated safely for ADHD using medication. 7,[79][80][81][82][83][84][85] The majority of medication studies focus on methylphenidate but data also exist on the effects of amphetamine salts, α agonists, atomoxetine, and risperidone. Behavioral therapies and school interventions are effective in children with developmental ADHD.…”