title: Effect of methylphenidate on the quality of life in children with epilepsy and attention deficit hyperactivity disorder: and open-label study using an osmotic-controlled release oral delivery system.
abstract: This open study explored whether methylphenidate could be tolerated and effective in improving the quality of life (QOL) and attention deficit hyperactivity disorder (ADHD) symptoms of children with epilepsy and ADHD. Twenty-five subjects (aged 10.1 +/- 3.0 years) with ADHD and epilepsy were recruited at an outpatient clinic in Seoul, Korea. We used the Quality of Life in Childhood Epilepsy Questionnaire (QOLCE), ADHD rating scale (ARS) and clinical global impression (CGI) in this study. Osmotic-controlled release oral delivery system (OROS) methylphenidate, 1.0 +/- 0.4 mg/kg/day, was administered for 55.2 +/- 7.5 days. The QOL subscales including physical restriction (p = 0.005), self-esteem (p = 0.002), memory (p < 0.001), language (p = 0.005), other cognition (p < 0.001), social interaction (p = 0.002), behaviour (p < 0.001), general health (p = 0.002) and QOL (p < 0.001) were significantly increased and the ARS (p < 0.001) and CGI-Severity of illness scores (p < 0.001) were significantly reduced after medication. Although 60% of subjects had experienced adverse effects, most were tolerable and only two subjects withdrew from the study owing to unbearable adverse effects (anorexia and insomnia). Two subjects had seizure attacks during the study period without having to discontinue the trial drug. Despite limitations related to the small sample size and the open design of the present pilot study, our results suggest that OROS methylphenidate may be well tolerated and effective in reducing ADHD symptoms and improving QOL in this patient population.
authors.affiliation: Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. hiyoo@amc.seoul.kr
authors.forename: Hanik K
authors.initials: HK
authors.lastname: Yoo
authors.forename: Subin
authors.initials: S
authors.lastname: Park
authors.forename: Hee-Ryung
authors.initials: HR
authors.lastname: Wang
authors.forename: Joong Sun
authors.initials: JS
authors.lastname: Lee
authors.forename: Kunwoo
authors.initials: K
authors.lastname: Kim
authors.forename: Kyoung-Won
authors.initials: KW
authors.lastname: Paik
authors.forename: Mi Sun
authors.initials: MS
authors.lastname: Yum
authors.forename: Tae-Sung
authors.initials: TS
authors.lastname: Ko
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D015897:Comorbidity; D003692:Delayed-Action Preparations; D004305:Dose-Response Relationship, Drug; D016503:Drug Delivery Systems; D004359:Drug Therapy, Combination; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000523:psychology*; D004829:Epilepsy, Generalized / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage* / Q000009:adverse effects; D010865:Pilot Projects; D011788:Quality of Life / Q000523:psychology*; D056910:Republic of Korea
chemical_list: D000927:Anticonvulsants; D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D008774:Methylphenidate