title: Attention deficit/hyperactivity disorder and interictal epileptiform discharges: it is safe to use methylphenidate?
abstract: OBJECTIVE
  This study investigated whether interictal epileptiform discharges (IED) on a baseline routine EEG in children with ADHD was associated with the occurrence of epileptic seizures (Sz) or influenced the use of methylphenidate (MPH) during 2 years follow-up.
  
  
  METHODS
  A retrospective chart-review of 517 ADHD children with EEG revealed IED in 39 cases. These patients (IED group) were matched on age and gender with 39 patients without IED (non-IED group). We measured at baseline, 1 year and 2 years Sz occurrence, the use of MPH and antiepileptic drug (AED).
  
  
  RESULTS
  At baseline, 12 patients in the IED group had active epilepsy and three of them had Sz during the last year. 36 (92.3%) patients were treated with MPH. Initial positive response to MPH was achieved in 83.3% compared with 89.2% in the non-IED group. At 1 and 2 years follow-up, three patients who also had Sz at baseline and difficult to treat epilepsy, had Sz, without changes in seizure frequency. We found no statistically significant differences between the groups with respect to MPH use at 1 year and at 2 years. Ten patients from IED group, who did not have confirmed epilepsy diagnosis, temporarily used AEDs during the first year of follow-up.
  
  
  CONCLUSIONS
  Despite the occurrence of IED, the use of MPH was safe during 2 years follow-up. IED predict the Sz occurrence in children with previous epilepsy, but does not necessarily suggest an increased seizure risk. A caution is warranted in order not to overestimate the significance of temporarily occurrence of IED.
authors: Stavanger University Hospital, Division of Psychiatry, Department of Child and Adolescent Psychiatry, Stavanger, Norway. Electronic address: dobrinko.socanski@sus.no.
authors: Dobrinko
authors: D
authors: Socanski
authors: Stavanger University Hospital, Department of Neurology, Stavanger, Norway.
authors: Dag
authors: D
authors: Aurlien
authors: Stavanger University Hospital, Department of Clinical Neurophysiology, Stavanger, Norway.
authors: Anita
authors: A
authors: Herigstad
authors: Centre for Child and Adolescent Psychiatry, University of Aarhus, Denmark.
authors: Per Hove
authors: PH
authors: Thomsen
authors: Stavanger University Hospital, Division of Psychiatry, Stavanger, Norway; Department of Clinical Medicine, University of Bergen, Norway.
authors: Tor Ketil
authors: TK
authors: Larsen
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D012640:Seizures / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D000927:Anticonvulsants; D000697:Central Nervous System Stimulants; D008774:Methylphenidate
keywords: Antiepileptic drug (AED); Attention-deficit/hyperactivity disorder (ADHD); Epilepsy; Interictal epileptiform discharges (IED); Methylphenidate (MPH)