Anti-seizure medications for neonates with seizures

Abiramalatha, Thangaraj; Thanigainathan, Sivam; Ramaswamy, Viraraghavan Vadakkencherry; Pressler, Ronit; Brigo, Francesco; Hartmann, Hans

doi:10.1002/14651858.cd014967.pub2

Cited by 2 publications

(2 citation statements)

References 131 publications

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“…However, in another recent phase IIb study, phenobarbital was found to be more effective than levetiracetam for the treatment of neonatal seizures (80% versus 26%, respectively), although more adverse effects were seen in subjects assigned to phenobarbital [169]. This finding is also supported by a recent (2023) Cochrane meta-analysis; it was concluded that phenobarbital as a first-line ASM is probably more effective than levetiracetam in achieving seizure control after the first loading dose and after the maximal loading dose (moderate-certainty of evidence) [166]. It should be noted that levetiracetam might have a neuroprotective effect on the neonatal brain by reducing neuronal apoptosis, as shown in animal models [170].…”

Section: Levetiracetammentioning

confidence: 76%

“…With respect to seizure control, two studies evaluating phenytoin and fosphenytoin in neonates, demonstrated similar efficacy to phenobarbital (45% and 56% became seizure free after initial treatment with phenytoin and fosphenytoin, respectively) [164,165]. Ιn a recent meta-analysis, high uncertainty was expressed about the effect of phenobarbital compared to phenytoin on achieving seizure control after a maximal loading dose of the ASM [166].…”

Section: Phenytoin/fosphenytoinmentioning

confidence: 99%

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Antibiotic Analgesic-Sedative and Antiseizure Medications Frequently Used in Critically Ill Neonates: A Narrative Review

Kontou,

Agakidou,

Chatziioannidis

et al. 2024

Preprint

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Several studies have shown that antibiotics, analgesic – sedative, and antiseizure medications are among the most commonly used medications in preterm and sick neonates. These infants are at high risk of developing nosocomial infections, central nervous system complications, and are exposed to numerous painful/stressful procedures. These severe, potentially life-threatening complications may have serious short- and long-term consequences and should be prevented and/or promptly treated. Previous studies and reviews have revealed significant variability in medications used in neonatal intensive care units (NICUs) worldwide, especially concerning the indications and dosages of first-line medications. This variability indicates the lack of adequate studies regarding the effectiveness and safety of these medications in neonates, especially the preterm ones. Important obstacles contributing to inadequate studies in preterm infants include difficulties in obtaining parental consent, physicians’ unwillingness to recruit preterm infants, the lack of license for use in neonates, and other scientific and ethical concerns. This review is an update on the use of antimicrobials – antifungals, analgesics – sedatives, and antiseizure medications used in neonates, focusing on existing evidence or knowledge gaps regarding their pharmacokinetics, indications, safety, dosage regimen (dose, dosing interval, route of administration), and evidence-based guidelines for the optimal use in neonates.

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Section: Levetiracetammentioning

confidence: 76%