ADHD in Adults with Epilepsy: A Guide for Neurologists
Attention-deficit/hyperactivity disorder (ADHD) and epilepsy have one of the lesser known and yet highly debated relationships in neuropsychiatry. Similar to anxiety and depression, ADHD has a bidirectional relationship with epilepsy, in which individuals with epilepsy are more likely than the gener...
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| Language: | English |
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Elsevier
2025-03-01
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| Series: | Epilepsy & Behavior Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589986424000960 |
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| author | Luciana Giambarberi Halley B. Alexander Heidi Munger Clary |
| author_facet | Luciana Giambarberi Halley B. Alexander Heidi Munger Clary |
| author_sort | Luciana Giambarberi |
| collection | DOAJ |
| description | Attention-deficit/hyperactivity disorder (ADHD) and epilepsy have one of the lesser known and yet highly debated relationships in neuropsychiatry. Similar to anxiety and depression, ADHD has a bidirectional relationship with epilepsy, in which individuals with epilepsy are more likely than the general population to have ADHD and vice versa. Most importantly, an untreated psychiatric condition can affect quality of life. Although the management of ADHD in PWE has been debated due to perceived seizure risk related to ADHD medications, a consensus has developed based on early pediatric studies that support the treatment of ADHD. However, the management of adults with ADHD, particularly in PWE, remains relatively unexplored. This critical gap in knowledge will be addressed using an illustrative case study followed by practical tips on the identification and pharmacologic management of ADHD in adults with epilepsy. The management of ADHD in PWE should begin with a thorough history, medication assessment for cognitive risk, and the addition of a brief ADHD screening tool, such as the Adult ADHD Self-Report Scale (ASRS). Treatment with stimulants, such as methylphenidate, and non-stimulants, such as atomoxetine, are effective. Caution, however, should be taken for any patients with history of bipolar disorder, as some ADHD medications may exacerbate symptoms of other psychiatric conditions. Patients can also be referred to psychotherapy, such as cognitive behavior therapy (CBT) for ADHD, in addition to or in lieu of medications, thus further minimizing potential pharmacological risk. Patients who have tried and failed multiple ADHD medications and/or who carry a more complex psychiatric history should be referred to a psychiatrist. |
| format | Article |
| id | doaj-art-bd0f75248beb4e1baf2c60e113c2e363 |
| institution | OA Journals |
| issn | 2589-9864 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Epilepsy & Behavior Reports |
| spelling | doaj-art-bd0f75248beb4e1baf2c60e113c2e3632025-08-20T01:58:27ZengElsevierEpilepsy & Behavior Reports2589-98642025-03-012910073910.1016/j.ebr.2024.100739ADHD in Adults with Epilepsy: A Guide for NeurologistsLuciana Giambarberi0Halley B. Alexander1Heidi Munger Clary2Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; Department of Psychiatry, Wake Forest University School of Medicine, Winston-Salem, NC 27103, USA; Corresponding author.Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USADepartment of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USAAttention-deficit/hyperactivity disorder (ADHD) and epilepsy have one of the lesser known and yet highly debated relationships in neuropsychiatry. Similar to anxiety and depression, ADHD has a bidirectional relationship with epilepsy, in which individuals with epilepsy are more likely than the general population to have ADHD and vice versa. Most importantly, an untreated psychiatric condition can affect quality of life. Although the management of ADHD in PWE has been debated due to perceived seizure risk related to ADHD medications, a consensus has developed based on early pediatric studies that support the treatment of ADHD. However, the management of adults with ADHD, particularly in PWE, remains relatively unexplored. This critical gap in knowledge will be addressed using an illustrative case study followed by practical tips on the identification and pharmacologic management of ADHD in adults with epilepsy. The management of ADHD in PWE should begin with a thorough history, medication assessment for cognitive risk, and the addition of a brief ADHD screening tool, such as the Adult ADHD Self-Report Scale (ASRS). Treatment with stimulants, such as methylphenidate, and non-stimulants, such as atomoxetine, are effective. Caution, however, should be taken for any patients with history of bipolar disorder, as some ADHD medications may exacerbate symptoms of other psychiatric conditions. Patients can also be referred to psychotherapy, such as cognitive behavior therapy (CBT) for ADHD, in addition to or in lieu of medications, thus further minimizing potential pharmacological risk. Patients who have tried and failed multiple ADHD medications and/or who carry a more complex psychiatric history should be referred to a psychiatrist.http://www.sciencedirect.com/science/article/pii/S2589986424000960ADHDAttention-deficit and hyperactivity disorderAntiseizure medicationEpilepsySeizuresMethylphenidate |
| spellingShingle | Luciana Giambarberi Halley B. Alexander Heidi Munger Clary ADHD in Adults with Epilepsy: A Guide for Neurologists Epilepsy & Behavior Reports ADHD Attention-deficit and hyperactivity disorder Antiseizure medication Epilepsy Seizures Methylphenidate |
| title | ADHD in Adults with Epilepsy: A Guide for Neurologists |
| title_full | ADHD in Adults with Epilepsy: A Guide for Neurologists |
| title_fullStr | ADHD in Adults with Epilepsy: A Guide for Neurologists |
| title_full_unstemmed | ADHD in Adults with Epilepsy: A Guide for Neurologists |
| title_short | ADHD in Adults with Epilepsy: A Guide for Neurologists |
| title_sort | adhd in adults with epilepsy a guide for neurologists |
| topic | ADHD Attention-deficit and hyperactivity disorder Antiseizure medication Epilepsy Seizures Methylphenidate |
| url | http://www.sciencedirect.com/science/article/pii/S2589986424000960 |
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