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OBJECTIVE-To pilot a randomized controlled trial of OROS-Methylphenidate (MPH) to treat ADHD plus epilepsy.METHOD-Thirty-three patients, 6-18 years, taking antiepileptic drugs and with a last seizure 1-60 months prior were assigned to a maximum daily dose of 18, 36, or 54mg of OROS-MPH in a double-blind placebo-controlled crossover trial. In the past year, Dr. Stephen Faraone has received consulting fees and has been on Advisory Boards for Eli Lilly, McNeil and Shire and has received research support from Eli Lilly, Pfizer, Shire and the National Institutes of Health. In previous years, Dr. Faraone has received consulting fees or has been on Advisory Boards or has been a speaker for the following sources: Shire, McNeil, Janssen, Novartis, Pfizer and Eli Lilly. In previous years he has received research support from Eli Lilly, Shire, Pfizer and the National Institutes of Health. Dr. Joseph Biederman is currently receiving research support from the following sources: Alza, AstraZeneca, Bristol Myers Squibb, Eli Lilly and Co., Janssen Pharmaceuticals Inc., McNeil, Merck, Organon, Otsuka, Shire, NIMH, and NICHD. In 2009, Dr. Joseph Biederman received a speaker's fee from the following sources: Fundacion Areces, Medice Pharmaceuticals, and the Spanish Child Psychiatry Association. In previous years, he has received research support, consultation fees, or speaker's fees for/from the following additional sources: Abbott, AstraZeneca, Celltech, Cephalon, Eli Lilly and Co., Esai, Forest, Glaxo, Gliatech, Janssen, McNeil, NARSAD, NIDA, New River, Novartis, Noven, Neurosearch, Pfizer, Pharmacia, The Prechter Foundation, Shire, The Stanley Foundation, UCB Pharma, Inc. and Wyeth. Dr. Blaise Bourgeois has received grant/research support from Eisai, Ovation and UCB Pharma. In the past two years, he has also received consulting fees from Genzyme and Bayer Material Science.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. RESULTS-There were no serious adverse events and no carry over effects in the crossover trial. OROS-MPH reduced ADHD symptoms more than placebo treatment. There were too few seizures during the active (5) and placebo arms (3) to confidently assess seizure risk; however, considering exposure time, we observed an increased daily risk of seizures with increasing dose of OROS-MPH, suggesting that potential safety concerns need further study. NIH Public AccessCONCLUSION-A larger study to assess the effect of OROS-MPH on seizure risk is needed. A crossover design including subjects with frequent seizures could maximize power and address high patient heterogeneity and re...

Background-ADHD coexisting with epilepsy is poorly understood, thus we compared the clinical correlates and psychiatric comorbidities in 36 children with epilepsy and ADHD, aged 6 to 17 years enrolled in an ADHD treatment trial, to those reported in the literature on children with ADHD without epilepsy. Methods-Measures included the Kiddie Schedule for Affective Disorders and Schizophrenia forSchool-Age Children (KSADS), the Wechsler Abbreviated Scale of Intelligence (WASI), and the Scales for Independent Behavior-Revised (SIB-R).Results-Mean IQ was 86±19, and SIB-R Standard Score was 72±26. The ADHD-Combined subtype, composed of both inattentive and hyperactive symptoms, was most frequent (58%). Sixtyone percent exhibited a comorbid disorder, including anxiety disorders (36%), and Oppositional Defiant Disorder (31%).Conclusions-Comorbidity in ADHD with epilepsy is similar to that of ADHD without epilepsy reported in the literature. These preliminary data argue that the pathophysiology of ADHD has common components in both populations.