Seizures and ADHD Meds

[maddiesmom]

I have heard that ADHD meds can exacerbate seizures but I hear about lots of kids with epilepsy on them anyway. Is there definitive research on this?

 

[Nakamova]

This article gives some good info on the topic:
http://professionals.epilepsy.com/page/treatment_stimulants.html

Here a relevant chunk:

Gross-Tsur et al.89 studied 30 children with epilepsy and ADHD who were taking antiepileptic drugs (AEDs). All children were monitored for a 2-month period and then given a morning dose of MPH (methylphenidate) of 0.3 mg/kg for 2 months. All children who were seizure-free on AEDs alone remained seizure-free. Of the five subjects whose seizure activity was incompletely controlled by the AEDs, three showed an increase in seizures, one showed no change, and one was seizure-free. These investigators also found no significant changes in AED levels or EEG findings. On parent reports, 70% of all the subjects showed a positive response to MPH.

BTW, you might want to look into neurofeedback as an ADHD treatment (and also as an epilepsy treatment), if you can find a practitioner near you.

 

[maddiesmom]

Thanks so much for this. Is Neurofeedback safe for seizures? Has it ever been found to increase seizures?

 

[Nakamova]

Neurofeedback is slowly moving into the mainstream as a potential epilepsy treatment. It's been hampered by the lack of large-scale studies, but there have been quite a few smaller scale successes, plus promising anecdotal evidence (including from CWE members). You can read more about it here: http://www.coping-with-epilepsy.com/forums/f22/eeg-neurofeedback-501/ and here: http://www.coping-with-epilepsy.com/forums/f32/neurofeedback-rebeccas-story-2733/

Side effects are virtually non-existent. As long as you are with a qualified practitioner who is familiar with epilepsy-related protocols, there should be miniscule to zero risk of seizure increase (less risk than with AEDs).

 

[maddiesmom]

Well, I wonder if its a good sign that I was actually able to get a consult at our local neurofeedback center tomorrow morning. So far, just a consult as I have MANY questions. Wish us luck. Does anyone see any downsides?

 

[Nakamova]

The downsides of neurofeedback are the costs and the time commitment. It's not guaranteed to be covered by insurance. Costs vary, but there's usually a fee for an initial qEEG and then the sessions themselves. I spoke with a practitioner near me who said they recommend 20 to 40 half-hour sessions (one or two sessions a week), with the second 20 sessions discounted if certain benchmarks aren't met. I think the total was going to run around $3500 - $4000. I also saw fairly impressive data on improvements made by kids with ADD and ADHD.

Let us know how it goes tomorrow! And don't be afraid to ask a lot of questions.

 

[maddiesmom]

The meeting went well. Of course, when you are talking to people who do Neurofeedback it sounds amazing. My question afterwards was whether it was safe for epilepsy. In the newer form of NF, LENS, they actually deliver a mild current to your brain via the EEG sensors. In all of the open studies listed (they are recruiting lots of PTSD soldiers for studies) they say it cannot be used if you have uncontrolled seizures. But many people use this precisely because they have uncontrolled seizures. I really need to understand the risk a bit more. The upsides sounds fantastic, but I really do not want an increase or new types of seizures.

 

[Nakamova]

I would think that the active version (no current) would be a bit safer than the passive version. But it's hard to know without real data.