"For the most part, mainstream drugs used to treat asthma are safe-in this case safe from psychological consequences," said Bruce Bender, Ph.D., head of Neuropsychology at National Jewish Medical and Research Center and principal investigator of the study. "Patients with chronic illness in general tend not to take their medications. When a parent has doubts about a medication, that tendency is amplified, often to the child's detriment in the long run. We hope that this study will help alleviate some of the fears parents may have about giving a child beclomethasone or theophylline."
Parents of more than 100, 6- to 17-year-old children with asthma completed behavioral questionnaires at the beginning of the study, at one month and one year. The children, who all had been diagnosed with asthma on average for 7 years, were tested for attention, concentration, memory, problem solving and learning skills. No significant side effects or differences between beclomethasone and theophylline were found in the study.
Although theophylline has a reputation among doctors and parents for causing behavioral problems in children, this research shows this isn't true in the age group examined. "No one has really looked at the potential psychological side effects of inhaled steroids before," Bender said. "There have been a couple of case reports that stated children developed serious behavior problems on inhaled steroids, but these reports often aren't accurate."
The study found that neither beclomethasone nor theophylline should be avoided because of concern over significant psychological side effects. But there may be a subset of pre-school age children who do have behavioral changes while taking either of the drugs.
Theophylline continues to be prescribed to some people with severe asthma, although doctors have started moving away from its use in general.
"Possible psychological changes in response to asthma medications must be addressed," Bender said. "Careful discussion with the child and the parents may lead to a decision to try another medication. But in some cases, particularly where more serious changes in mood or behavior are noted, referral to a mental health professional may prove more effective."
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