Amphetamines are the mainstay of therapy for patients displaying impulsivity, distractibility, and motor overactivity in the constellation of a diagnosis of attention deficit hyperactivity disorder (ADHD). The prevalence rate of this disorder in patients with mental retardation can be up to 11%, although making the diagnosis often is difficult at best. Amphetamines can exacerbate stereotypies, but they remain the drugs of choice for this disorder.5
Comorbid epilepsy in patients with ADHD may complicate the use of amphetamines. Methylphenidate has been evaluated in children with ADHD and epilepsy. Those patients in whom the epilepsy was well controlled had no increase in seizure activity (n = 25). However, three of the five children with continued seizure activity experienced an increase in seizure rate.112 In contrast, in patients with a seizure disorder secondary to brain injury, seizures were less frequent with the use of methylphenidate.113
Because amphetamines in high dosages certainly can be associated with seizure activity; low dosages are recommended, as is slow titration.17
Reviewed and revised June 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.
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