Efficacy and safety of methylphenidate in treating ADHD symptoms in children and adolescents with uncontrolled seizures: A Brazilian sample study and literature review

ObjectiveAttention-deficit/hyperactivity disorder (ADHD) is observed in 30% of children and adolescents with epilepsy. Recent studies have demonstrated the safety of methylphenidate (MPH) in patients with controlled epilepsy. There are few studies of patients with uncontrolled epilepsy. The goal was to study the efficacy and safety of MPH use in children and adolescents diagnosed with ADHD and uncontrolled epilepsy.MethodsWe evaluated 24 patients ranging from 7 to 16 years of age who took MPH for 6 months. Inclusion criteria were at least two epileptic seizures in the previous 6 months and a diagnosis of ADHD based on DSM-IV criteria.ConclusionPatients were classified according to ADHD subtype as follows: 41.7% inattentive type, 37.5% combined, and 20.8% hyperactive/impulsive type; 58.3% had partial epilepsy and 41.7% generalized epilepsy. There was an overall improvement in ADHD symptoms in 70.8% of patients, and there was no increase in frequency of epileptic seizures in 22 patients (91.6%).

Research highlights
► There are few studies of methylphenidate use by patients with attention-deficit/hyperactivity disorder and uncontrolled epilepsy.
► The efficacy and safety of methylphenidate use were studied in 24 patients with uncontrolled epilepsy/ADHD.
► Symptoms of attention-deficit/hyperactivity disorder improved in 70.8% of the patients.
► There was no increase in the frequency of epileptic seizures in 22 patients (91.6%).