title: [Pharmacological management of attention deficit hyperactivity disorder with methylphenidate and atomoxetine within a context of epilepsy].
abstract: BACKGROUND
  The prevalence of attention deficit hyperactivity disorder (ADHD) in patients with epilepsy stands at around 30-40%, especially the inattentive subtype, while other studies on children diagnosed with ADHD show figures that vary from 6.1% to 30% which present alterations in the electroencephalogram and epilepsy problems. Although clinical practice guidelines advise against treatment with psychostimulants in ADHD that is comorbid with epilepsy, especially when the latter is not considered active, some researchers and practitioners recommend caution as regards beginning this pharmacological therapy, while less research has been conducted on the use of non-psychostimulants.
  
  
  OBJECTIVE
  To review the patient records of children with epilepsy and ADHD who received pharmacological treatment with psychostimulants and non-psychostimulants for an attention disorder.
  
  
  METHODS
  The study involved a sample of 23 patients aged 5-16 years. The type of epilepsy and the clinical course and electroencephalogram were analysed at both one and two years after beginning pharmacological treatment of ADHD.
  
  
  RESULTS
  At two years, one patient presented a crisis and two patients continued to display paroxysmal activity in the electroencephalogram.
  
  
  CONCLUSIONS
  The data presented show that pharmacological treatment of ADHD does not exacerbate the epilepsy in well-controlled patients, although it is advisable to take into account factors such as the type of antiepileptic drug, the type of drug for ADHD and the cognitive profile, in order to favour a satisfactory development. In epileptic children with learning difficulties, it is necessary to evaluate the mechanisms involved in attentional processes, since they may well be compromised and in need of a more specific treatment.
authors.affiliation: Instituto Valenciano de Neurologia Pediatrica (INVANEP), 46010 Valencia, Espana.
authors.forename: Fernando
authors.initials: F
authors.lastname: Mulas
authors.forename: Patricia
authors.initials: P
authors.lastname: Roca
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Ros-Cervera
authors.forename: Rubén
authors.initials: R
authors.lastname: Gandía-Benetó
authors.forename: Pedro
authors.initials: P
authors.lastname: Ortiz-Sánchez
mesh_terms: D000293:Adolescent; D000069445:Atomoxetine Hydrochloride / Q000009:adverse effects / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D004569:Electroencephalography / Q000187:drug effects; D004827:Epilepsy / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D000069445:Atomoxetine Hydrochloride