Antihistamines Increase ADHD Symptoms in Kids With AD

Children with atopic dermatitis (AD) only, attention-deficit/hyperactivity disorder (ADHD) only, and comorbid AD and ADHD have increased behavioral issues and a decreased quality of life vs the general population, according to a recent study. In children with AD only, prior antihistamine use was significantly associated with increased symptoms of ADHD.

Previous evidence has suggested an association between AD and ADHD. However, little is currently known about underlying mechanisms and ways to best identify subgroups of AD patients with a higher risk for ADHD.
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For their study, the researchers assessed children age 6 to 12 years, implementing a factorial design. Participants were categorized into 4 groups: AD only (n = 42), ADHD only (n = 34), AD+ADHD (n = 31), and healthy controls (n = 47).

Symptoms of ADHD and other behavioral problems, quality of life, parenting stress, and sleeping problems were compared between groups using validated instruments. Additionally, clinical signs (via objective Scoring Atopic Dermatitis [SCORAD]), symptoms (via Patient Oriented Eczema Measure [POEM], Visual Analogue Scale [VAS] pruritus, and VAS sleeping problems), and previous treatment of AD were investigated among children with ADHD only in order to determine disease patterns associated with ADHD symptoms.

Results indicated that children with AD only, ADHD only, and comorbid AD+ADHD had significantly increased behavioral issues and a decreased quality of life vs healthy controls. Furthermore, children with AD only demonstrated significantly more ADHD symptoms compared with controls.

The researchers had observed that previous antihistamine use was significantly associated with increased ADHD symptoms in children with AD only. However, they noted that current clinical signs and AD symptoms were not related to the level of ADHD symptoms.

“Even if the clinical diagnosis of ADHD is excluded, children with AD show increased levels of ADHD symptoms,” the researchers concluded. “Further investigations need to determine whether early antihistamine exposure is a major risk factor for ADHD or a surrogate for previous AD severity and/or associated sleeping problems.”

—Christina Vogt

Reference:

Schmitt J, Buske-Kirschbaum A, Tesch F, et al. Increased attention-deficit/hyperactivity symptoms in atopic dermatitis are associated with history of antihistamine use [Published online October 4, 2017]. Eur J Allergy Clin Immunol. doi:10.1111/all.13326.