To compare the potential efficacy of immediate-release methylphenidate (Ritalin) vs. placebo in treating cognitive deficits in epilepsy, researchers conducted a double-blind, randomized, single-dose, 3-period crossover study (n=35). Patients with epilepsy and chronic cognitive complaints participated in three medication visits (approximately 1 week apart) where they were administered one of the blinded preparations (placebo, methylphenidate 10mg or 20mg).
Researchers evaluated cognitive outcome based on a score calculated from the performance on the Conners Continuous Performance Test 3, Symbol-Digit Modalities Test, and Medical College of Georgia Paragraph Memory Test. They also monitored adverse events and seizure frequency among patients.
Of the 35 adults with epilepsy who were enrolled, 31 completed the study. The mean epilepsy duration among patients was 12.5 years.
The data indicated a statistically significant performance benefit seen with methylphenidate (Ritalin) 10mg (P=0.030) and methylphenidate (Ritalin) 20mg (P=0.034) doses. No seizures were seen in either of the methylphenidate arms. Cognitive “fogginess,” anxiety/agitation, and tachycardia were cited as adverse effects leading to withdrawal.
Findings from this single-dose study suggest possible efficacy in treating cognitive deficits in patients with epilepsy but additional studies are required, study authors concluded.