J Pediatr 1997 Apr;130(4):670-674 
Epilepsy and attention deficit hyperactivity disorder: is 
methylphenidate safe and effective?
Gross-Tsur V, Manor O, van der Meere J, Joseph A, Shalev RS
Pediatric Neurobehavioral Unit, Shaare Zedek Medical Center, Jerusalem, 
Israel. 
OBJECTIVE: To study the safety and efficacy of methylphenidate in 
children with the dual diagnosis of epilepsy and attention deficit 
hyperactivity disorder (ADHD). STUDY DESIGN: Thirty children, aged 6.4 
to 16.4 years, with epilepsy and ADHD were studied during a 4-month 
period. During the initial 2 months of the study, the children were 
treated with antiepileptic drugs (AEDs) only, and for the remaining 2 
months, methylphenidate was added at a morning dose of 0.3 mg/kg. They 
underwent neurologic assessment, brain computed tomography, IQ testing, 
and assessment with the Childhood Behavior Checklist at baseline before 
methylphenidate therapy. Electroencephalography, AED determinations, and 
the continuous-performance task (CPT) test were done at baseline and 
after 2 months of methylphenidate therapy. A double-blind, crossover 
design was used to compare the effects of methylphenidate versus placebo 
on an electroencephalogram, AED levels, and the CPT. On the 2 days of 
testing, the child received AEDs and a capsule containing either placebo 
or methylphenidate. RESULTS: None of the 25 children of this sample who 
were seizure free had attacks while taking methylphenidate. Of the 5 
children with seizures, 3 had an increase in attacks, whereas the other 
2 showed no change or a reduction. There were no significant changes in 
AED levels or electroencephalographic findings. Methylphenidate 
benefited 70% of children according to parental report; methylphenidate 
also enhanced performance on the CPT. Side effects of methylphenidate 
were mild and transient. CONCLUSION: Methylphenidate is effective in 
treating children with epilepsy and ADHD and safe in children who are 
seizure free. Caution is warranted for those still having seizures while 
receiving AED therapy. 
Publication Types:
.Corrected and republished article 
Corrected and republished article originally printed in J Pediatr 1997 
Jan;130(1):40-4
Comments:
.Comment in: J Pediatr 1997 Jan;130(1):6-9 
               The Few. The Proud. The Chosen.
                     markprobe@aol.com
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