Authors: McAfee, Andrew T.; Holdridge, Karen C.; Johannes, Catherine B.; Hornbuckle, Kenneth; Walker, Alexander M.

Source: Current Drug Safety, Volume 3, Number 2, May 2008 , pp. 123-131(9)

Publisher: Bentham Science Publishers

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

Document Type: Research article

Publication date: 2008-05-01

More about this publication?

• Current Drug Safety publishes frontier reviews on all the latest advances on drug safety. The journal's aim is to publish the highest quality review articles in the field. Topics covered include: adverse effects of individual drugs and drug classes, management of adverse effects, pharmacovigilance and pharmacoepidemiology of new and existing drugs, post-marketing surveillance. The journal is essential reading for all researchers and clinicians involved in drug safety.

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