Adverse antiepileptic drug effects

Perucca, Piero; Carter, Jewell; Vahle, Victoria; Gilliam, Frank

doi:10.1212/01.wnl.0000345667.45642.61

Cited by 206 publications

(121 citation statements)

References 34 publications

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“…2) and these data should therefore be explored in larger populations. As observed in the first study, most AEs in study 208 were common CNS-related symptoms found with other AED therapies and may be partially related to concomitant AED dosing (13,14).…”

Section: Discussionmentioning

confidence: 57%

Tolerability and safety of perampanel: two randomized dose-escalation studies

Krauss

Bar

Biton

et al. 2011

Acta Neurologica Scandinavica

100

103

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Objectives -To evaluate, for the first time in patients with epilepsy, the tolerability and safety of escalating doses of oral perampanel, a novel, selective, non-competitive AMPA antagonist, as adjunctive therapy for refractory partial-onset seizures. Materials and methods -Two consecutive, randomized, double-blind, dose-escalation studies recruited adults (18-70 years) with uncontrolled partial-onset seizures receiving one to three concomitant antiepileptic drugs. In study 206, patients were treated for 12 weeks (8-week dose-titration, 4-week dosemaintenance) with placebo or perampanel (up to 4 mg ⁄ day, dosed once-or twice-daily). In study 208, patients received placebo or perampanel once-daily (up to 12 mg) for 16 weeks (12-week titration, 4-week maintenance). Results -Overall, 153 patients were randomized into study 206 (perampanel twice-daily, n = 51; perampanel oncedaily, n = 51; placebo, n = 51). Study 208 included 48 patients (perampanel once-daily, n = 38; placebo, n = 10). The highest dose in study 206 -4 mg ⁄ day -was well tolerated, with similar proportions of patients tolerating once-daily (82.4%) and twice-daily (82.4%) perampanel and placebo (82.4%) treatments. In study 208 most patients tolerated doses of ‡ 6 mg perampanel once-daily in a KaplanMeier analysis. In both studies, the most common adverse events were CNS-related; most were of mild ⁄ moderate severity. ConclusionsPerampanel was well tolerated across doses of 4-12 mg ⁄ day. The studies showed preliminary evidence of efficacy and identified doses to be evaluated in larger clinical studies.

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Section: Discussionmentioning

confidence: 57%

Tolerability and safety of perampanel: two randomized dose-escalation studies

Krauss

Bar

Biton

et al. 2011

Acta Neurologica Scandinavica

100

103

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“…The development of several new AEDs (gabapentin, lamotrigine, levetiracetam, oxcarbazepine, tiagabine, topiramate, zonisamide), that combine efficacy and low incidence of side effects has been improving the quality of care for epileptic patient 10,11 . These new second-generation drugs have more favorable pharmacokinetics such as low protein binding and no hepatic metabolization which minimize adverse effects and drug interactions 21,22 . In the VA Cooperative #428 Study, a randomized, doubleblind study of gabapentin, lamotrigine and carbamazepine in elderly community-dwelling epilepsy patients with newly diagnosed seizures, the authors concluded that lamotrigine and gabapentin should be considered as initial therapy for older patients with newly diagnosed seizures because their better tolerability and effective seizure control.…”

Section: Discussionmentioning

confidence: 99%

Antiepileptic drugs patterns in elderly inpatients in a Brazilian tertiary center, Salvador, Brazil

Assis

Nascimento

Costa

et al. 2014

Arq. Neuro-Psiquiatr.

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Epilepsy is very prevalent among elderly inpatients and treatment is far from ideal. Objective: To analyze prescribing patterns of antiepileptic drugs (AEDs) for hospitalized elderly with epilepsy, their relations with comorbidities and comedications. Method: We assessed prescription regimen of elderly patients that were under AED use for treatment of epileptic seizures, during hospitalization. One hundred and nine patients were enrolled. AED regimen was categorized into two groups: Group 1 defined as appropriate (carbamazepine, oxcarbazepine, valproic acid, gabapentin, clobazan and lamotrigine) and Group 2 as inappropriate (phenytoin and phenobarbital). Results: We found 73.4% of patients used inappropriate AEDs (p,0.001). Monotherapy was prescribed for 71.6% of patients. The most common comorbidity was hypertension. Potentially proconvulsant drugs as comedications were used for nearly half of patients. Conclusion: Inappropriate AED therapy was commonly prescribed regimen for elderly inpatients. Some recommendations are discussed for a better care of elderly inpatients with epilepsy.Keywords: antiepileptic drugs, elderly, epilepsy, epileptic seizures. RESUMOEpilepsia é frequente entre idosos hospitalizados e o tratamento costuma ser aquém do ideal. Objetivo: Analisar os padrões de prescrição de drogas antiepilépticas para idosos hospitalizados com epilepsia, bem como sua relação com comorbidades e comedicações. Método: Revisamos os prontuários de pacientes idosos internados com diagnóstico de epilepsia e que estavam em uso de droga antiepiléptica (DAE) durante o período de hospitalização. Cento e nove pacientes foram incluídos no estudo. O regime de DAE foi categorizado em dois grupos: Grupo 1, definido como apropriado (carbamazepina, oxcarbazepina, ácido valpróico, gabapentina, clobazam e lamotrigina) e Grupo 2, como inapropriado (fenitoína e fenobarbital). Resultados: 73,4% dos pacientes usaram DAE inapropriadas (p,0,001). Regime de monoterapia foi usado por 71,6% dos pacientes. Hipertensão arterial foi a comorbidade mais frequente. Medicações concomitantes potencialmente proconvulsivantes foram usadas por quase metade desta população. Conclusão: Regime de droga antiepiléptica inapropriada foi o mais utilizado em pacientes idosos internados. São discutidas algumas recomendações para melhor cuidado ao paciente idoso hospitalizado com epilepsia.Palavras-chave: drogas antiepilépticas, idosos, epilepsia, crises epilépticas.

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“…Antiepileptic drugs (AEDs) are known to have a high propensity for adverse effects (AEs) because of their mechanism of action and their metabolic pathway, with up to 80% of patients experiencing an adverse event [5][6][7][8]. AEs are contributors to poor drug compliance, which can be as high as 30% to 50% of adults living with epilepsy, low quality of life and drop outs from drug therapy [4,5,9].…”

Section: Introductionmentioning

confidence: 99%

Adverse effects of carbamazepine monotherapy among patients in Nigeria: a pilot study and implications

et al. 2017

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Abstract.Background and aims: Antiepileptic drugs do cause adverse effects, affecting quality of life, adherence and seizures. Consequently, need to study this among Nigerian patients. Methods: Descriptive cross-sectional study assessing the extent of adverse effects with carbamazepine monotherapy and potential factors. Results: 54 patients (64.3 %) reported no adverse effects, while 30 did. Commonest adverse effects were memory problems followed by headaches, restlessness, tiredness and depression. Adverse effects were significantly higher in females, with females with low educational levels having significantly higher rates. Dose, co-medications, seizure control and comorbid conditions did not significantly affect adverse effects. Conclusions: Perception of adverse effects was common in patients on carbamazepine monotherapy, more common in women than men. Educational status was important in women. IntroductionEpilepsy is a chronic neurological condition that affects between 65 to 70million people worldwide [1,2], with drug therapy the mainstay of the treatment. It is estimated that 70% of patients will respond to the medicines prescribed whilst the remainder will need surgery and other forms of therapy to achieve seizure control [2,3,4].

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Adverse antiepileptic drug effects

Abstract: Background: Adverse effects (AEs) of antiepileptic drugs (AEDs) are a major impediment to opti-

Cited by 206 publications

References 34 publications

Tolerability and safety of perampanel: two randomized dose-escalation studies

Tolerability and safety of perampanel: two randomized dose-escalation studies

Antiepileptic drugs patterns in elderly inpatients in a Brazilian tertiary center, Salvador, Brazil

Adverse effects of carbamazepine monotherapy among patients in Nigeria: a pilot study and implications

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