A Critique of Studies Investigating the Association of Theophylline to Psychologic or Behavioral Performance

A number of recent studies have investigated the relationship between theophylline and behavior or psychologic performance. The result has been the widespread notion that theophylline is associated with behavioral or psychologic problems. This review critiques 10 studies conducted on the topic. Three conclusions are that (1) all the 10 investigations contain major procedural flaws that are indicative of what is usually found in preliminary investigations, (2) there is no evidence that the findings are reflective of a learning disability, and (3) the results fail to meet criteria established for the diagnosis of an attention deficit hyperactivity disorder (ADHD). Because the effect of theophylline is similar to the effect of caffeine on behavior and psychologic functions in children and because the substances are chemically related, a parsimonious explanation of the reported effects of theophylline is that they reflect effects produced by all caffeinelike substances. A methodology for investigating this explanation is outlined. The review concludes with a suggested procedure for examining asthmatic children when it is suspected that they may react in a negative way to theophylline. This would permit physicians to more accurately tailor medication regimens for their patients without relying solely upon a trial-and-error approach. © 1988, Mary Ann Liebert, Inc. All rights reserved.

Duke Scholars

Author Kathryn E. Gustafson Psychiatry, Child & Family Mental Health & Community Psychia ...