Association between attention-deficit/hyperactivity disorder and epilepsy in pediatric populations.
There is a bidirectional relationship between attention-deficit/hyperactivity disorder (ADHD) and epilepsy. ADHD increases seizure risk, while patients with epilepsy have an increased prevalence of ADHD. The reasons explaining this association are not fully understood. Proposed mechanisms include effects of antiepileptic medications, underlying neurodevelopmental vulnerability, the effects of chronic seizures and subclinical epileptiform activity on cognitive functions and adrenergic dysfunction. There may also be a common genetic defect underlying both disorders in some families. Antiepileptics associated with ADHD-like side effects include phenobarbital, gabapentin, vigabatrin and topiramate. Methylphenidate has been studied in a double-blind setting against placebo for treatment of ADHD comorbid with epilepsy, and has a good risk-benefit ratio. Amphetamine, atomoxetine, clonidine and guanfacine only have case series to support their use and bupropion should be avoided.
Hamoda
Hesham M
HM
Clinical Fellow in Psychiatry, Children's Hospital Boston and Harvard Medical School, 300 Longwood Avenue Boston, MA 02115, USA. hesham.hamoda@childrens.harvard.edu
Guild
Danielle J
DJ
Gumlak
Sarah
S
Travers
Brian H
BH
Gonzalez-Heydrich
Joseph
J
D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000453:epidemiology*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D010372:Pediatrics
D000697:Central Nervous System Stimulants