Abstract
Purpose: To estimate the rate of new-onset seizure in ADHD patients in relation to ADHD pharmacotherapy. Methods: A retrospective cohort study of 34,727 patients, ages 6 to 17, with at least two insurance claims bearing ADHD diagnoses during 2003 in the United Healthcare database. Incidence of seizure was calculated for observation time during treatment with atomoxetine and stimulants/bupropion. Results: Seizure incidence among ADHD patients was 4.5/1,000 person-years (p-y; 95% confidence interval 3.7 – 5.5). ADHD patients who received any ADHD medication had an incidence of 3.8/1,000 p-y (3.0 – 4.8) compared to 8.7 (5.8 – 12.4) for patients who did not receive any ADHD medication. The relative risk (RR) for current vs non-use of atomoxetine was 1.1 (0.6 – 2.1). For stimulants and bupropion, the RR for current vs non-use was 0.8 (0.6 – 1.3). Elevated seizure risks were found in association with central nervous system (CNS) disease (OR 3.9, 1.2 – 10.9), CNS medications (OR 2.2, 1.3 – 3.6), metabolic disease (OR 2.9, 1.1 – 6.8), and psychiatric disease risk factors (OR 1.7, 1.1 – 2.6). Conclusions: In this study, there was no statistically significant association between use of atomoxetine or stimulants and seizure risk in children ages 6 to 17 years with ADHD and without prior seizure disorder.
Keywords: ADHD, epilepsy, seizure, stimulants, atomoxetine, retrospective cohort study
Current Drug Safety
Title: The Effect of Pharmacotherapy for Attention Deficit Hyperactivity Disorder on Risk of Seizures in Pediatric Patients as Assessed in an Insurance Claims Database
Volume: 3 Issue: 2
Author(s): Andrew T. McAfee, Karen C. Holdridge, Catherine B. Johannes, Kenneth Hornbuckle and Alexander M. Walker
Affiliation:
Keywords: ADHD, epilepsy, seizure, stimulants, atomoxetine, retrospective cohort study
Abstract: Purpose: To estimate the rate of new-onset seizure in ADHD patients in relation to ADHD pharmacotherapy. Methods: A retrospective cohort study of 34,727 patients, ages 6 to 17, with at least two insurance claims bearing ADHD diagnoses during 2003 in the United Healthcare database. Incidence of seizure was calculated for observation time during treatment with atomoxetine and stimulants/bupropion. Results: Seizure incidence among ADHD patients was 4.5/1,000 person-years (p-y; 95% confidence interval 3.7 – 5.5). ADHD patients who received any ADHD medication had an incidence of 3.8/1,000 p-y (3.0 – 4.8) compared to 8.7 (5.8 – 12.4) for patients who did not receive any ADHD medication. The relative risk (RR) for current vs non-use of atomoxetine was 1.1 (0.6 – 2.1). For stimulants and bupropion, the RR for current vs non-use was 0.8 (0.6 – 1.3). Elevated seizure risks were found in association with central nervous system (CNS) disease (OR 3.9, 1.2 – 10.9), CNS medications (OR 2.2, 1.3 – 3.6), metabolic disease (OR 2.9, 1.1 – 6.8), and psychiatric disease risk factors (OR 1.7, 1.1 – 2.6). Conclusions: In this study, there was no statistically significant association between use of atomoxetine or stimulants and seizure risk in children ages 6 to 17 years with ADHD and without prior seizure disorder.
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McAfee T. Andrew, Holdridge C. Karen, Johannes B. Catherine, Hornbuckle Kenneth and Walker M. Alexander, The Effect of Pharmacotherapy for Attention Deficit Hyperactivity Disorder on Risk of Seizures in Pediatric Patients as Assessed in an Insurance Claims Database, Current Drug Safety 2008; 3 (2) . https://dx.doi.org/10.2174/157488608784529233
DOI https://dx.doi.org/10.2174/157488608784529233 |
Print ISSN 1574-8863 |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-3911 |
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