ADHD medication poses no increased seizure risk in epilepsy
Use of attention‐deficit/hyperactivity disorder (ADHD) medication does not contribute to an increased risk of seizure in patients with epilepsy, a study suggests.
The study included 21,557 individuals with a seizure history, of whom 6,773 were <19 years of age and met the criteria for epilepsy and 1,605 of these were receiving continuous antiepileptic drug (AED) treatment. Conditional Poisson regression facilitated comparison of the seizure rate during the 24 weeks before and after initiation of ADHD medication with the rate during the same 48 weeks in the previous year, whereas Cox regression was used to compare the seizure rate during ADHD medication periods with the rate during nonmedication periods.
A total of 995 individuals initiated ADHD medication during follow‐up. In this group, the rate of seizure risk did not significantly differ during the 24 weeks before and after medication initiation (83 events in 57 individuals) relative to the same period in the previous year (82 events in 60 individuals).
In the entire cohort, 11,754 seizure events occurred during 136,846 person‐years, and 1,855 individuals had at least one ADHD medication period. Compared with nonmedication periods, ADHD medication periods were associated with a 27-percent lower rate of acute seizures (hazard ratio, 0.73; 95 percent CI, 0.57–0.94).
Associations were similar in young people with epilepsy and continuous AED treatment.
Overall, the findings suggest that epilepsy should not automatically preclude patients from receiving ADHD medications, researchers said.
The present study has important clinical implications given that ADHD is commonly diagnosed in childhood or adolescence—although concerns about pharmaceutical treatment of ADHD in individuals with epilepsy are not limited to childhood—and clinical decisions regarding treatment initiation may be especially challenging in children with active epilepsy, they pointed out.