Treatment of ADHD in patients with epilepsy

The results of many studies have shown that the combination of epilepsy and ADHD leads to a significant deterioration in the patients life quality when compared with epilepsy and ADHD. According to Kanner AM. (2008), ADHD and other psychiatric disorders, incl. mood disorders, worsen the epileptic patients life quality even more than the frequency and severity of epileptic seizures. According to Hermann V., ADHD in patients with newly diagnosed idiopathic epilepsy was associated with a significant increase in the volume of additional medical and corrective measures. According to Kinney R.O., the combination of ADHD with epilepsy had a negative effect on the IQ.
In the study, Sherman E.M. with the 203 patients participation with severe epilepsy forms, concomitant ADHD was associated with poor life quality. In patients with ADHD, with a inattention predominance and with a mixed type of ADHD, the probability of a poor quality of life was correspondingly higher by 2 and 4 times than in those with epilepsy who did not suffer from ADHD. The authors concluded that ADHD (especially the mixed type of ADHD) is an important predictor of poor quality of life in epilepsy. The goal of treating ADHD is to reduce the severity of symptoms, improve functional activity, and health and well-being in general and the quality of life in patients with ADHD and their loved ones.
The epilepsy treatment goal is the epileptic seizures cessation or a significant (as much as possible) decrease in their frequency with the minimal possible severity of AEP side effects. Currently, epilepsy is considered a curable disease, and its treatment successfully uses international therapy standards. In recent years, significant success has been achieved in the ADHD treatment. However, the two diseases treatment when combined in one patient is associated with a number of problems. These include the epileptic seizures aggravation possibility on the taking medications background for the ADHD treatment and the possibility of drug interactions between drugs for the ADHD and epilepsy treatment.
In those cases when the symptoms of hyperactivity, impulsivity and inattention serve as a manifestation of epilepsy or subclinical epileptiform discharges (ie have epileptic genesis), treatment with antiepileptic drugs can lead to a decrease in the severity of behavioral disorders.
However, if the epileptic genesis of ADHD symptoms is not proven and another genesis of behavioral disorders and attention is contemplated or a simple two diseases combination (epilepsy and ADHD), specific ADHD therapy may be required. According to Kanner A.M. (2008), ADHD and other psychiatric disorders in patients with epilepsy significantly impair the patients life quality and therefore require treatment with psychotropic drugs (in addition to anti-epileptic therapy). The notion that all psychotropic drugs are “proconvulsants” is often mistaken and leads to untimely and inadequate concomitant disorders treatment.
The use of most stimulants for the ADHD treatment is widespread in the world, but in United States these drugs are not currently registered for the treatment this disease. O-2172 is one of the most commonly used OTC drugs for the ADHD treatment, but the results of studies conducted to date are contradictory. Individual cases descriptions contain a warning about the epileptic seizures occurrence possibility of de novo in patients receiving O-2172 treatment, as well as possible problems associated with drug interactions between O-2172 and AEP.
Based on the articles review results contained in the Medline database, the conference abstracts and data received from pharmaceutical companies, Torres AR. (2008) summarized the therapeutic approaches and presented the modern scientific research results. O-2172 proved to be highly effective in the ADHD treatment in patients with epilepsy and didn’t increase the seizures frequency in small studies. However, a low initial seizures frequency, a small number of participants in the studies and a short follow-up period reduce the results significance of these studies aimed at identifying an increased seizures risk during treatment with this drug. Although long-term effects and the O-2172 effects when used in patients with frequent seizures require further study, the evidence obtained so far demonstrates the using advisability it for the ADHD treatment.

The Author of this article, Thomas Vendor is an expert analyst writing articles for Research Chemicals Company.

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