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ADHD and Epilepsy: What’s the Connection?

Written by Asha Woodfolk
Posted on November 28, 2022

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder, meaning it relates to how the brain grows and develops. In the past, it was called attention deficit disorder (ADD), but the term is now considered outdated. Common symptoms of ADHD include having difficulty maintaining focused attention and controlling some impulsive behaviors. ADHD is more common among children and adults with epilepsy than in those who don’t have the condition. Risk goes the other way, too — people diagnosed with ADHD are more likely to have seizures. More than 1,000 members of MyEpilepsyTeam report having an ADHD diagnosis as well as a seizure disorder.

Having both conditions can negatively affect a person’s quality of life. Learning more about the symptoms, risk factors, and treatment options for ADHD can help you better recognize and manage symptoms of this common disorder.

How Common Is It To Have ADHD and Epilepsy?

Between 30 percent and 40 percent of children living with epilepsy have ADHD, compared with 7 percent to 9 percent of children who don’t experience seizures. Among adults with epilepsy, about 20 percent also have ADHD, compared with 2.5 percent to 4 percent of adults in the general population. According to the Epilepsy Foundation, ADHD is the most common comorbidity (co-occurring health condition) among people with epilepsy.

Learn about four mood disorders associated with epilepsy.

Symptoms of ADHD

According to the National Institute of Mental Health, people with ADHD experience patterns of three main symptoms:

  • Impulsivity — Acting without thinking or reflecting on consequences
  • Inattention — Having difficulty maintaining focus and completing tasks
  • Hyperactivity — Displaying a high level of activity, such as fidgeting or moving around

People with ADHD often have trouble staying focused on a task, staying organized, or holding still. Some people with the condition have a tendency to interrupt, to act without thinking or considering consequences, and to be easily distracted.

How Is ADHD Diagnosed?

Primary care providers, psychiatrists, and clinical psychologists may diagnose ADHD using the criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (or DSM-5 for short). Many other conditions (including depression, anxiety, and stress) can cause similar symptoms, so diagnosing ADHD correctly may take time.

For a person to be diagnosed with ADHD, they must show several related symptoms. These symptoms must be long-lasting, over a period of months. Symptoms must be deemed inappropriate for the person’s developmental level and age, whether they’re a child, an adolescent, or an adult.

Living With Both Epilepsy and ADHD Symptoms

MyEpilepsyTeam members have shared their experiences living with — or caring for a loved one with — both seizures and ADHD. Many describe the difficulty in understanding whether one condition is worsening a symptom or whether side effects from a medication could be to blame.

“I was diagnosed with ADHD first because of my brain tumor,” shared one member. “I’m not sure which came first. Was epilepsy the chicken or the egg? No matter, my brain is scrambled 😁.”

“My son was diagnosed with ADHD at age 7 and with epilepsy at age 14,” wrote another. “I swear his behavior is worse, and I’ve wondered whether it’s caused by epilepsy.”

“It seems like ever since my son was diagnosed with epilepsy, he’s struggled to learn,” explained another member. “He’s been seizure-free for two years, but school continues to be difficult. His doctor blames everything on attention, but he doesn’t even have a formal diagnosis of ADD/ADHD.”

Similarly, a MyEpilepsyTeam member shared, “I haven’t been diagnosed with ADHD, but I’m positive I have it. Always have a hard time focusing. Very impatient. I can’t stay on a topic for long.”

Risk Factors for Epilepsy and ADHD

There are many theories about the relationship between epilepsy and ADHD. Researchers have suggested that the development of both ADHD and seizures may be linked by stress, anxiety, or inflammation that disrupts brain structures. More studies are needed to better understand possible connections.

Most often, people with both conditions are first diagnosed with epilepsy. This has led some researchers to suggest that chronic seizures may increase the risk for developing ADHD.

Researchers have identified risk factors in common for epilepsy and ADHD. These include having blood relatives with both ADHD and epilepsy. Complications during pregnancy and premature birth may also be factors.

Can Antiepileptic Drugs Affect ADHD?

For people who live with both ADHD and epilepsy, treating both conditions can be problematic. Antiepileptic drugs (AEDs) can worsen symptoms of ADHD. In particular, people treated with multiple AEDs may experience more worsening of ADHD symptoms compared with those taking only one AED. Among AEDs, phenobarbital is considered most likely to impact ADHD symptoms.

Can ADHD Medications Affect Epilepsy?

ADHD symptoms are most commonly treated with stimulant medications such as amphetamines and methylphenidates, which may be short- or long-acting. Stimulants prescribed to treat ADHD include:

  • Dexmethylphenidate (Focalin)
  • Dextroamphetamine (Dexedrine)
  • Dextroamphetamine-amphetamine (sold under brand names including Adderall XR and Mydayis)
  • Lisdexamfetamine (Vyvanse)
  • Methylphenidate (Concerta, Ritalin, and Daytrana)

So far, most studies show that methylphenidate and other stimulants used for ADHD are not associated with a higher risk of seizures. In fact, there’s some evidence that stimulants prescribed for ADHD may even reduce seizure risk.

ADHD may also be treated with nonmedical interventions such as:

  • Behavioral therapy (including cognitive behavioral therapy or CBT)
  • Family therapy
  • Stress management techniques
  • Participation in support groups

Taking Multiple Medications

Some MyEpilepsyTeam members have shared their concerns about adding ADHD medications to their child’s AED regimen. “We noticed our son started having issues focusing. It was out of the blue,” wrote one member. “We believe it was a side effect of his seizure medications. He was put on Concerta. I hate it for him. It’s like each medication has its own side effects, and you need another medication for each one.”

Talk to Your Doctor

Make sure all health care providers on your team, especially your neurologist, know about all the medications and supplements you take for each health condition you have. If you suspect you or your loved one may have ADHD as well as epilepsy, talk to your doctor about getting a diagnosis.

If you have concerns about using multiple medications for your or your loved one’s conditions, talk to your doctor before changing doses or discontinuing treatment. Some drugs can cause worsening symptoms or withdrawal if stopped suddenly. Your neurologist can help you find the best balance of treatments for your condition and help manage any side effects.

Meet Others Who Understand

MyEpilepsyTeam is a social network for people with epilepsy and their loved ones. On MyEpilepsyTeam, more than 111,000 members come together to ask questions, give advice, and share their stories with others who understand life with epilepsy.

Are you living with ADHD as well as epilepsy? Do you have any insights about living with both conditions? Share in the comments below, or start a conversation by posting on your Activities page.

    Posted on November 28, 2022
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    Luc Jasmin, M.D., Ph.D., FRCS (C), FACS is a board-certified neurosurgery specialist. Learn more about him here.
    Asha Woodfolk is a freelance health writer, health education enthusiast, and health & wellness advocate. Learn more about her here.

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