Theophylline Cognition and behavioural disorders in children: clinical study

29 asthmatic children aged 7-12 years (mean 92) participated in a study to evaluate the possible effects of theophylline on learning and behaviour in chidren receiving long term theophylline therapy . At the time of entry theophylline had been administered on a 'minimum dosing schedule of twice daily ' for ~ 1 month in all patients. Sodium cromoglycate [cromolyn sodium) was added to their treatment for ~ 3 weeks and patients were then randomised to theophylline alone or sodium cromoglycate alone, in a double-blind double-dummy design for ~ 2 weeks.

Of the 24 patients who completed the study 13 received theophylline throughout and 11 were switched to sodium cromoglycate. The difference in scores for the subtests of the Revised Wechsler Intelligence Scale for Children , Benton Visual Retention test , Selective Reminding test , Stroop tests I and II and the Child Behaviour Checklist between the 2 treatment groups was significant only for the Stroop I test (p < 0.03) . However, children receiving sodium cromoglycate showed greater improvement in all 6 measures vs baseline than theophylline-treated patients (p < 0.001). Examination of the relationship between duration of theophylline administration and scores for the depression and the obsessive­compulsive subscales of the Child Behaviour Checkl ist revealed significant correlation (r = 0.472, P < 0.03 and r = 0.433, P = 0.04, respectively) and indicated a h igher than normal incidence of behavioural and emotional problems.

Theophylline levels were 0.5-1 6.6 (mean 8.9) .ug/ml at baseline and 5.5-27 (mean 11 .7) .ug/ ml post-treatment.

In the authors ' opinion the data suggest that ' ... theophylline may impair learning and behalf/our in children with asthma' especially when the drug ' . .. is used for extended periods of time'.

Furukawa CT, Du Hamel TR, Weimer L, Shapiro GG, Pierson WE , et aL Journal of Allergy and Clinical Immunology 81 : 83-88, Jan 1988 .. 59

12 REACTIONS'" 7 May 1988 0157-7271 / 88/ 0507-0012/ 0$01.00/ 0 © ADIS Press