Effects of Theophylline on Behavior and Learning in Children with Asthma

Rappaport, Leonard; Coffman, Harry D.; Guaré, Renata de Oliveira; FENTON, TERRANCE; DeGraw, Charles; Twarog, Frank J.

doi:10.1097/00004703-198606000-00028

Cited by 8 publications

(10 citation statements)

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“…However relatively little work has been reported on theophylline, and most of this relates to children (see e.g. Rappaport et al, 1989). The fact that theophylline and other Correspondence: Dr Brian Tiplady, Astra Clinical Research Unit, 10 York Place, Edinburgh EH1 3EP.…”

Section: Introductionmentioning

confidence: 99%

A comparison of the CNS effects of enprofylline and theophylline in healthy subjects assessed by performance testing and subjective measures.

Tiplady¹,

Fagan²,

Lamont³

et al. 1990

Brit J Clinical Pharma

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1 The effects of intravenous infusions of enprofylline, theophylline, and placebo on subjective ratings and on psychological test performance were studied in a double-blind crossover experiment in 12 healthy subjects who abstained from caffeine throughout the experimental procedures. 2 Mean plasma concentrations of enprofylline were: mean 2.9 mg 1-1 (range 1.9-3.4).Those for theophylline were: mean 12.1 mg 1-1 (range 9.0-14.4).3 Performance on the auditory vigilance task showed a significant improvement with theophylline compared with both enprofylline and placebo. The correct detection rates (out of 90) were 50.3, 43.4 and 39.1 respectively. A similar effect was seen with finger tapping rates: 404, 394 and 390 taps min-' respectively. Other measures showed no significant effects, although choice reaction time showed a trend towards faster responses with theophylline. 4 Subjective ratings showed that subjects were significantly more alert with theophylline than with enprofylline. Subjects reported themselves as significantly more dizzy and ill with both active drugs compared with placebo. 5 These results suggest that emprofylline largely lacks the CNS stimulant effects of theophylline, but that the incidence of other unwanted effects of the drugs may be similar.

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Section: Introductionmentioning

confidence: 99%

A comparison of the CNS effects of enprofylline and theophylline in healthy subjects assessed by performance testing and subjective measures.

Tiplady¹,

Fagan²,

Lamont³

et al. 1990

Brit J Clinical Pharma

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“…Evidence from blinded studies, however, indicates that theophylline side effects are relatively infrequent and appear to be quite similar to the effects of a closely related xanthine, caffeine. These changes, which tend to be subtle, included increased anxiety (Bender and Milgrom, 1992) and increased hand tremor (Joad et al, 1986;Rappaport et aL, 1989;Bender and Milgrom, 1992). Stein and Lerner (1993 ; Table I) documented decreased parental complaints about behavioral problems in the second week of theophylline treatment and concluded that theophylline-induced behavior change decreases with the initial habituation to the medication.…”

Section: Theophyllinementioning

confidence: 99%

“…For example, Rappaport et al (1989), in a well-controlled double-blind crossover design, found no indications of neuropsychological compromise due to the medication regimen or asthma. While this study was well controlled, problems with selection of subjects are quite pronounced in this investigation.…”

Section: Theophyllinementioning

confidence: 99%

“…2To whom correspondence should be addressed. 3National Jewish Center for Immunology and Respiratory Medicine, Room 6213, 1400 Jackson St.,Denver,Colorado,80206. ing interfering with normal psychological/emotional adaptation (Cadman et aL, 1987;Orr et al, 1984), school adaptation (Freudenberg et al, 1980;McLoughlin et al, 1983;Gutstadt et al, 1989;Rappaport et al, 1989), and neuropsychological functioning (Kasenberg and Bloom, 1987;Schlieper et al, 1991). The recently published National Heart, Lung and Blood Institute (NHLBI) Guidelines for the Diagnosis and Management of Asthma (1991) reported that approximately 10 million people in the United States have been diagnosed with asthma; 7-12% of all children exhibit asthma symptoms (Gergen et al, 1988;Burr et al, 1989).…”

Section: Introductionmentioning

confidence: 99%

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Neuropsychological dysfunction in asthmatic children

Annett

Bender

1994

Neuropsychol Rev

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Neuropsychological dysfunction associated with pediatric asthma is reviewed. Significant methodological confounds associated with clinical research, including problems with the objective measure of asthma, are prevalent in many studies. Most evidence does not support the belief that asthma alone results in homogeneous neuropsychological compromise. Studies of adverse reactions to asthma medications indicate medication-specific effects including slight improvements in some aspects of neuropsychological functioning, such as attention, and deficiencies in other aspects of neuropsychological functioning, such as memory. The acute neuropsychological effects of various medication regimens appears to be reversible with cessation of the asthma medication under suspicion, although no data yet exist regarding the long-term effects of therapeutic dosages of asthma medications upon a developing nervous system. The hypothetical effects of asthma on school performance have been related to non-neuropsychological variables such as a child's socioeconomic status, though there is also evidence suggesting that poorly controlled asthma is related to learning problems. Implications for pediatric neuropsychologists are discussed.

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“…Rappaport et al (1989) studied 17 asthmatic children of normal intelligence. A doubleblind crossover design was employed after an initial period to determine the appropriate dose of theophylline for each subject.…”

Section: The Children Were Assessed With the Wechsler Intelligence Scmentioning

confidence: 99%

Learning, School Performance, and Children with Asthma

Celano

Geller

1993

J Learn Disabil

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Children with asthma may be at risk for decreased school functioning due to acute exacerbations, increased absenteeism, iatrogenic effects of their asthma medication, and the stress associated with a chronic illness. The purpose of this article is to critically review extant research pertaining to the school functioning of children with asthma, including studies of school attendance, school performance, the effects of asthma medications on learning and behavior, and the role of psychological variables in the development of functional impairments. There is not sufficient evidence to suggest that children with asthma are at significantly higher risk for poor school performance than children without asthma. Factors that may contribute to poor school performance among children with asthma include iatrogenic effects of oral steroids, poor medical management of the disease, and psychological problems. Recommendations for improving the school functioning of children with asthma are discussed.

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Effects of Theophylline on Behavior and Learning in Children with Asthma

Cited by 8 publications

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A comparison of the CNS effects of enprofylline and theophylline in healthy subjects assessed by performance testing and subjective measures.

A comparison of the CNS effects of enprofylline and theophylline in healthy subjects assessed by performance testing and subjective measures.

Neuropsychological dysfunction in asthmatic children

Learning, School Performance, and Children with Asthma

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