Interventions for ADHD in children & adolescents with epilepsy: A review and decision tree to guide clinicians

Epilepsy Behav. 2022 Oct:135:108872. doi: 10.1016/j.yebeh.2022.108872. Epub 2022 Aug 28.

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common pediatric epilepsy comorbidities. Treating ADHD in the context of epilepsy can be overwhelming for parents and clinicians. Current frontline treatment for ADHD is stimulant medication. However, some parents of pediatric patients with epilepsy have concerns about adding additional medication to their child's epilepsy regimen and/or about adverse effects of stimulant medication. Non-medication ADHD treatments including psychosocial interventions and ketogenic diet have also shown success in improving ADHD symptoms. Our focused review provides an easy-to-use guide for clinicians on ADHD interventions and combinations of interventions for pediatric patients with epilepsy and ADHD. Our guide includes information from 8 electronic databases for peer-reviewed, English language studies of psychosocial treatments for youth with epilepsy and ADHD. One hundred eight studies were selected based on inclusion criteria (21 systematic reviews, 12 meta-analyses, 8 literature reviews, 6 population surveys, 31 clinical trials, 20 cross-sectional studies, and 10 retrospective reviews). Results indicated that stimulant medication is a frontline treatment for ADHD symptoms in youth with epilepsy, with important caveats and alternatives.

Keywords: ADHD; Epilepsy; Interventions.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity* / drug therapy
  • Attention Deficit Disorder with Hyperactivity* / therapy
  • Central Nervous System Stimulants* / therapeutic use
  • Child
  • Cross-Sectional Studies
  • Decision Trees
  • Epilepsy* / drug therapy
  • Epilepsy* / therapy
  • Humans
  • Retrospective Studies

Substances

  • Central Nervous System Stimulants