Medication for attention-deficit/hyperactivity disorder (ADHD) was associated with lower seizure risk among patients with ADHD, according to results of a retrospective cohort study published in Neurology. These findings are not consistent with the current hypothesis that ADHD medication increases seizure risk and may offer new information on the safety of pharmacotherapy for those with ADHD.
Researchers extracted patient and prescribed drug claim data from 2005 to 2014 from the Truven Health MarketScan Commercial Claims and Encounters databases. A total of 801,838 patients (40.79% female) aged 5 to 64 years with newly diagnosed ADHD were included in subsequent analyses. Investigators defined ADHD medications as either stimulants or atomoxetine hydrochloride, a nonstimulant medication approved to treat ADHD. In patients who ever received medication for ADHD, 1.44% of male and 1.63% of female patients had at least 1 seizure event, compared with 2.14% of male (odds ratio [OR] 0.63; 95% CI, 0.60-0.67) and 2.58% of female (OR 0.61; 95% CI, 0.57-0.64) patients who had never received medication for ADHD.
These results indicate that patients treated with ADHD medication have an appreciably lower risk for seizure events than those who do not receive medication. In fact, within-individual comparisons showed 29% and 49% lower odds of a seizure event during months that patients received medication in those with and without a seizure history, respectively. An additional 2-year cumulative association analysis found that prolonged ADHD medication use was not correlated with an increased seizure risk among patients both with and without prior seizure events.
Researchers noted that the observational nature of the study limited the certainty of its conclusions and acknowledged that data extracted from health insurance claims may not have accurately captured medication compliance or seizure events. However, these results may still mitigate concerns by physicians regarding the pharmacologic treatment of individuals with ADHD.
Wiggs KK, Chang Z, Quinn PD, et al. Attention-deficit/hyperactivity disorder medication and seizures [published online February 23, 2018]. Neurology. doi:10.1212/WNL.0000000000005213