Methylphenidate for attention problems in epilepsy patients: Safety and efficacy.

Methylphenidate for attention problems in epilepsy patients: Safety and efficacy.
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哌甲酯治疗癫痫患者的注意力问题:安全性和有效性。

DOI:
10.1016/j.yebeh.2020.107627
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发表时间:
2021-03
期刊:
Epilepsy & behavior : E&B
影响因子:
--
通讯作者:
Meador KJ
Meador KJ
中科院分区:
其他
文献类型:
--
作者:
Leeman-Markowski BA;Adams J;Martin SP;Devinsky O;Meador KJ

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注意缺陷多动障碍(ADHD)儿童癫痫发作的风险增加,癫痫儿童ADHD患病率增加。成人癫痫患者通常由于多种因素而具有不同程度的注意力障碍,包括抗癫痫药物、频繁癫痫发作、发作间期放电、潜在病变和精神共病。目前,还没有批准的药物用于治疗癫痫相关的注意力功能障碍。哌甲酯(MPH)是一种兴奋剂,FDA批准用于治疗ADHD,通常用于儿童癫痫背景下的ADHD。大型数据库和注册研究表明MPH在ADHD和癫痫儿童中的安全性,对癫痫发作频率无显著影响。小型单次给药和开放标签研究表明MPH对癫痫相关注意力缺陷成人的疗效。MPH代表了癫痫引起的注意力障碍的一种可能的治疗方法,但需要进行大规模、随机、安慰剂对照、双盲研究。
Children with attention deficit hyperactivity disorder (ADHD) have an increased risk of seizures, and children with epilepsy have an increased prevalence of ADHD. Adults with epilepsy often have varying degrees of attentional dysfunction due to multiple factors, including antiseizure medications, frequent seizures, interictal discharges, underlying lesions, and psychiatric comorbidities. Currently, there are no approved medications for the treatment of epilepsy-related attentional dysfunction. Methylphenidate (MPH) is a stimulant, FDA-approved for the treatment of ADHD, and often used for ADHD in the setting of pediatric epilepsy. Large database and registry studies indicate safety of MPH in children with ADHD and epilepsy, with no significant effect on seizure frequency. Small single-dose and open-label studies suggest efficacy of MPH in adults with epilepsy-related attention deficits. MPH represents a possible treatment for attentional dysfunction due to epilepsy, but large, randomized, placebo-controlled, double-blinded studies are needed.
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