Methylphenidate for attention problems in epilepsy patients: Safety and efficacy

Epilepsy Behav. 2021 Feb:115:107627. doi: 10.1016/j.yebeh.2020.107627. Epub 2020 Dec 24.

Abstract

Children with attention deficit hyperactivity disorder (ADHD) have an increased risk of seizures, and children with epilepsy have an increased prevalence of ADHD. Adults with epilepsy often have varying degrees of attentional dysfunction due to multiple factors, including anti-seizure medications, frequent seizures, interictal discharges, underlying lesions, and psychiatric comorbidities. Currently, there are no approved medications for the treatment of epilepsy-related attentional dysfunction. Methylphenidate (MPH) is a stimulant, FDA-approved for the treatment of ADHD, and often used for ADHD in the setting of pediatric epilepsy. Large database and registry studies indicate safety of MPH in children with ADHD and epilepsy, with no significant effect on seizure frequency. Small single-dose and open-label studies suggest efficacy of MPH in adults with epilepsy-related attention deficits. Methylphenidate represents a possible treatment for attentional dysfunction due to epilepsy, but large, randomized, placebo-controlled, double-blinded studies are needed.

Keywords: Attention; Attention deficit hyperactivity disorder; Cognition; Epilepsy; Methylphenidate; Seizure.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Attention Deficit Disorder with Hyperactivity* / drug therapy
  • Attention Deficit Disorder with Hyperactivity* / etiology
  • Central Nervous System Stimulants* / adverse effects
  • Child
  • Double-Blind Method
  • Epilepsy* / complications
  • Epilepsy* / drug therapy
  • Humans
  • Methylphenidate* / adverse effects
  • Seizures / drug therapy
  • Treatment Outcome

Substances

  • Central Nervous System Stimulants
  • Methylphenidate