Epilepsy in a large cohort of children diagnosed with attention deficit/hyperactivity disorders (ADHD)

Socanski, D.; Aurlien, Dag; Herigstad, Anita; Thomsen, Per Hove; Larsen, Tor Ketil

doi:10.1016/j.seizure.2013.04.021

Cited by 55 publications

(39 citation statements)

References 40 publications

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“…Several epidemiological studies, with patient populations in the hundreds or thousands, indicate there may be a relationship between epilepsy and ADHD [108][109][110][111]. For instance, in a study using the Taiwanese health insurance database, epilepsy was found to be 3.94-fold more common in children and adolescents with ADHD (N = 3664) than in matched controls (N = 14,522), although the potential influence of ADHD medication upon seizures was not investigated [110].…”

Section: Introductionmentioning

confidence: 99%

The Safety of Atomoxetine for the Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Comprehensive Review of Over a Decade of Research

et al. 2016

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Atomoxetine is a noradrenergic reuptake inhibitor prescribed for attention-deficit/hyperactivity disorder (ADHD) that first gained approval in the USA in 2002 and has been authorized in 97 countries worldwide. The aim of this paper is to comprehensively review publications that addressed one or more of seven major safety topics relevant to atomoxetine treatment of children and adolescents (aged ≥6 years) diagnosed with ADHD. While the review focuses on children and adolescents, publications in which data from patients aged >18 years and from 6 to 18 years were analyzed in the same dataset were included. Using a predefined search strategy, including agreement of two reviewers when selecting papers, reduced the potential for bias. Using this process, we identified 70 eligible papers (clinical trials, epidemiological studies, and case reports) across the seven topics. We also referred to the European Summary of Product Characteristics (SPC) and US label. We found 15 papers about suicidality, three about aggression/hostility, seven about psychosis/mania, six about seizures, seven about hepatic effects, 29 about cardiovascular effects, and 28 about growth and development. The main findings (i.e., those from the largest and most well-conducted studies/analyses) are as follows. A large register-based study of pediatric and adult patients (6818 received atomoxetine) calculated a hazard ratio of 0.96 for suicide-related events during treatment with atomoxetine, and a meta-analysis of 23 placebo-controlled studies (N = 3883), published in 2014, found no completed suicides and no statistically significant association between atomoxetine and suicidality. The frequency of aggression/hostility was not statistically significantly higher with atomoxetine, e.g., experienced by 1.6 % (N = 21/1308) of atomoxetine-treated patients versus 1.1 % (N = 9/806) of placebo-treated patients in one meta-analysis. Symptoms of psychosis and mania were mainly observed in patients with comorbid bipolar disorder/depression. Based on spontaneous reports, during a 2-year period when 2.233 million adult and pediatric patients were exposed to atomoxetine, the reporting rate for seizures was 8 per 100,000 patients. In the manufacturer's database, atomoxetine was a "probable cause" of three hepatic adverse events (AEs) (all reversible hepatitis), and 133 hepatic AEs had possible confounding factors and were "possibly related" to atomoxetine, during 4 years when atomoxetine exposure had reached about 4.3 million patients. Rare cases of severe liver injury are described in the US label and European SPC; a case requiring liver transplantation is described in the US label. In a comprehensive review of a clinical trials database (N = 8417 received atomoxetine), most pediatric patients experienced modest increases in heart rate and blood pressure, and 8-12 % experienced more pronounced changes (≥20 bpm, ≥15 to 20 mmHg). However, in three long-term analyses (≥2 years), blood pressure was within age norms, and few patients discontinued due to cardiovascular AE...

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Section: Introductionmentioning

confidence: 99%

The Safety of Atomoxetine for the Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Comprehensive Review of Over a Decade of Research

et al. 2016

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“…48 Several researchers have supported this by reporting that ADHD, particularly the inattentive subtype, is often associated with epilepsy. 12,49 Identifying and managing attention deficit or ADHD in children with epilepsy is important for improving academic achievement and for formation and maintenance of interpersonal relationships. 50 Some limitations should be considered when interpreting our findings.…”

Section: Discussionmentioning

confidence: 99%

4.1 Medical and Psychiatric Comorbidities in Korean Children and Adolescents With Attention-Deficit/Hyperactivity Disorder

Kweon

Park²,

Lee³

et al. 2016

Journal of the American Academy of Child & Adolescent Psych

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“…It may be difficult to delineate ADHD symptoms from subtle seizures, especially in cases with inattentive subtype of ADHD which predominate in both epilepsy patients [2,15,31,32], and in patients with IED [7]. Another enigmatic association is that frequent IED (in more than 10% of the record) in the awake EEG can impair cognitive performance in children [33], and in some cases ADHD symptoms may be related to frequent epileptiform discharges activated by sleep as previously reported [34][35][36][37].…”

Section: Seizure Risk In Adhd Children With Ied and The Use Of Mph Anmentioning

confidence: 94%

“…We carried out a retrospective chart review of all patients aged 5-14 who were diagnosed with ADHD in accordance with DSM-IV TR [18]. For details see previous publications [7,15]. A digitized 20 min routine awake EEG with 21 electrodes (10-20 system) including hyperventilation and photic stimulation was performed.…”

Section: Participants and Proceduresmentioning

confidence: 99%

“…It is considered to be safe in children without epilepsy. On the other hand, there is limited research about the use of MPH in patients with epilepsy [11][12][13][14][15] and children with ADHD and IED [16]. A recent study found that clinicians appeared to be reluctant to diagnose and initiate treatment for ADHD in children with epilepsy [17].…”

Section: Introductionmentioning

confidence: 99%

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Attention deficit/hyperactivity disorder and interictal epileptiform discharges: It is safe to use methylphenidate?

Socanski

Aurlien

Herigstad

et al. 2015

Seizure

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Epilepsy in a large cohort of children diagnosed with attention deficit/hyperactivity disorders (ADHD)

Cited by 55 publications

References 40 publications

The Safety of Atomoxetine for the Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Comprehensive Review of Over a Decade of Research

The Safety of Atomoxetine for the Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Comprehensive Review of Over a Decade of Research

4.1 Medical and Psychiatric Comorbidities in Korean Children and Adolescents With Attention-Deficit/Hyperactivity Disorder

Attention deficit/hyperactivity disorder and interictal epileptiform discharges: It is safe to use methylphenidate?

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