PEDIATRICS Vol. 78 No. 6 December 1986, pp. 1133-1138
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Behavior Abnormalities and Poor School Performance Due to Oral Theophylline Use

Gary S. Rachelefsky MD1, Julie Wo RN1, Judith Adelson MA1, M. Ray Mickey PhD1, Sheldon L. Spector MD1, Roger M. Katz MD1, Sheldon C. Siegel MD1, and Albert S. Rohr MD1

1 From the Divisions of Allergy/Immunology, Departments of Pediatrics and Biomathematics, University of California at Los Angeles

Studies evaluating adverse effects of oral theophylline on learning and behavior have been performed on children with asthma receiving long-term theophylline therapy. To further differentiate the effects of asthma itself from the drugs used, we evaluated 20 asthmatic children (6 to 12 years of age) who had not received oral bronchodilators for at least 6 months. A double blind, placebo-controlled, parallel format was used with a 4-week theophylline or placebo period preceded by a 2-week baseline. Theophylline serum levels were maintained between 10 to 20 µg/mL. During baseline and treatment periods, the child's home and school behavior/performance were monitored independently by their parents and teachers using standardized report forms. A battery of psychologic tests was administered at the end of baseline and treatment periods. Seven children receiving theophylline were noted to have a change in school behavior and/or performance during their 4 weeks on drug compared to baseline, whereas none of the children receiving placebo were noted to be different (P = .004). Thus, the short-term administration of theophylline to asymptomatic asthmatic children not receiving oral bronchodilators can adversely affect school performance and behavior. Because this population represents the majority of asthmatic children, one needs to use theophylline cautiously in this age group, monitor school performance closely, or seek other treatment modalities.

Key Words: theophylline • behavior problems • learning problems • asthma

Submitted on December 13, 1985
Accepted on March 19, 1986


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