Epilepsy Clinical Trial
Official title:
Methylphenidate Treatment of Attentional and Cognitive Deficits in Epilepsy
Methylphenidate (MPH) has long been used to improve attention and cognitive difficulties
associated with ADHD, including in children with ADHD and epilepsy (Torres et al., 2008).
Methylphenidate (MPH) is also helpful in treating attention and other cognitive difficulties
in a variety of other neurological and medical conditions (Kajs-Wyllie, 2002; Prommer,
2012). We seek to evaluate the potential efficacy and safety of this medication in treating
attention deficits, as well as other cognitive difficulties, experienced by adult patients
with epilepsy.
To our knowledge, there are currently very few studies which explicitly examine the impact
of MPH on measureable attention deficits and other cognitive deficits in adult patients with
epilepsy. We hope to quantify what impact, if any, methylphenidate has on attention, in
addition to other specific measureable cognitive functions, in patients with cognitive
complaints and epilepsy, and contribute to a growing body of evidence which supports the
safety of methylphenidate's use for attention deficits in patients with epilepsy. As other
effective treatments for attention and other cognitive difficulties in patients with
epilepsy are not currently available, MPH could represent an important option in the
treatment of such patients.
Status | Not yet recruiting |
Enrollment | 45 |
Est. completion date | May 2015 |
Est. primary completion date | April 2015 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Both |
Age group | 18 Years to 60 Years |
Eligibility |
Inclusion Criteria: 1. For participants with seizures: - H/o seizures of any cause - Subjective cognitive complaints - Stable antiepileptic drug doses which are not expected to change during the study - Recent normal cardiac auscultation (may be done prior to enrollment by personal physician or study staff) 2. For healthy volunteers - No history of seizures or other neurological disorders - No history of cognitive complaints for any reason (including ADHD) - Not on any medications which would interfere w/ cognitive testing Exclusion Criteria: 1. IQ 2. History of an adverse reaction to methylphenidate 3. Seizure frequency > than 1 complex partial seizures (CPS) or absence seizure per month or > than 3 generalized tonic-clonic seizures (GTCS) per year 4. Age >60 or <18 5. Family history of sudden cardiac death at age <40 6. Personal medical history of - Arrhythmias, - Structural cardiac disease, - Other cardiac abnormality - Uncontrolled hypertension (BP >140/90 during study) - Uncontrolled tachycardia (HR >100 during study) - Progressive neurological disorders (e.g., dementia) which may interfere w/ cognition for reasons other than seizures - Glaucoma - Other major medical illnesses which may interfere with cognition or medication (e.g., severe liver or renal disease, active infections, etc) - Intellectual disability/mental retardation 7. Substance use history - Met criteria for substance use disorder within the past year - Any active illicit substance use - Alcohol use meeting criteria for substance abuse - Unwillingness to abstain from alcohol w/in 24 hours of testing 8. Personal psychiatric history - Any history of psychosis or mania - History of suicide attempts within the last year - Active suicidality 9. Severe cognitive impairments (e.g. aphasia) which render a participant unable to consent 10. Currently receiving medications which would be expected to interfere with the study tasks, if they cannot be held for study visits 11. Pregnancy or active breastfeeding 12. Women of childbearing potential who are sexually active and not willing or able to use a contraceptive strategy during the course of the study 13. Any other factor which may interfere w/ a participant's ability to consent or to complete the required cognitive tasks, or may significantly interfere with their performance on the required tests |
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
United States | Stanford University | Palo Alto | California |
Lead Sponsor | Collaborator |
---|---|
Kimford Jay Meador |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Conners' continuous performance test (CPT) | Scores on this test measure attentiveness/vigilance and response time. Primary measure will be confidence interval differences. | difference of 2 treatments (randomized to weeks 2, 3, or 4) from placebo (randomized to week 2, 3 or 4) | No |
Secondary | Seizure frequency/severity | Seizure diaries will be monitored for changes in seizure frequency and/or severity associated with methylphenidate use during 2 single dose exposures and during 1 month open label. | Change from baseline (day 1) to methylphenidate treatments (single doses randomized to weeks 2, 3, or 4, and end of one month treatment at end month 2) | Yes |
Secondary | Symbol-digit matching test | Symbol-digit matching test is a measure processing speed and working memory. | difference of 2 treatments (randomized to weeks 2, 3, or 4) from placebo (randomized to week 2, 3 or 4) | No |
Secondary | MCG paragraph memory test | MCG paragraph memory test is a measure verbal memory. | difference of 2 treatments (randomized to weeks 2, 3, or 4) from placebo (randomized to week 2, 3 or 4) | No |
Secondary | Beck Depression Inventory | Beck Depression Inventory is a questionnaire to assess mood. | Change from baseline to end of methylphenidate open label treatment (end month 2) | No |
Secondary | Beck Anxiety Inventory | Beck Anxiety Inventory is a questionnaire to assess anxiety. | Change from baseline to end of methylphenidate open label treatment (end month 2) | No |
Secondary | QOLIE-89 | QOLIE-89 is a questionnaire to assess quality of life and subjective cognitive effects. | Change from baseline to end of methylphenidate open label treatment (end month 2) | No |
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