Antiseizure Drugs and Movement Disorders

Sáenz‐Farret, Michel; Tijssen, Marina A. J.; Eliashiv, Dawn; Fisher, Robert S.; Sethi, Kapil D.; Fasano, Alfonso

doi:10.1007/s40263-022-00937-x

Cited by 11 publications

(8 citation statements)

References 203 publications

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“…pine, rufinamide, diazepam, primidone, felbamate, stiripentol, tiagabine and phenobarbital-had a lower probability of relating MDs. Our classification is consistent with earlier reports4,30,31 ; we all agree that ASMs such as lamotrigine, carbamazepine and valproate cause MDs, while ASMs such as clonazepam, zonisamide and gabapentin do not. In addition, the present study found pregabalin and topiramate to cause There are some drawbacks in our study that should be taken into consideration.…”

supporting

confidence: 92%

“…3 By contrast, some researchers believed that ASMs, rather than epilepsy itself, may directly increase the risk of developing idiopathic MDs. 4 They used a case-control study approach to compare the Parkinson disease and control groups in the UK Biobank database, and found that ASMs (valproate, lamotrigine, carbamazepine and levetiracetam) were associated with an 80% increased risk of developing Parkinson disease. 5 A postmarketing study based on the Italian spontaneous reporting system showed that 6.6% of children with ASMs developed MDs.…”

mentioning

confidence: 99%

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Movement disorders associated with antiseizure medications: A real‐world disproportionality analysis of the Food and Drug Administration Adverse Event Reporting System

Zhou

Wei

Chen

et al. 2023

Brit J Clinical Pharma

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AimsPatients with epilepsy often require long‐term use of antiseizure medications (ASMs) to control their seizures. However, movement disorders (MDs) related to ASMs can significantly impact their quality of life. This study aims to analyse MDs related to ASMs in the Food and Drug Administration Adverse Event Reporting System database to provide recommendations for safe medication.MethodsAll adverse drug reactions associated with 26 marketed ASMs in Food and Drug Administration Adverse Event Reporting System were extracted for analysis. Disproportionality analyses were used to assess the association between ASMs and MDs, and signal colour scale maps were created to identify potential ASM–MD safety signals.ResultsA total of 1921 cases experienced MDs while taking ASMs were included. A higher prevalence of MDs was observed in females compared to males. The association between specific MDs with ASMs was revealed, including known and unknown MDs such as tremors, Parkinson and paralysis. Lamotrigine and carbamazepine exhibited multiple significant MDs, while levetiracetam and pregabalin were linked to the earlier onset of MDs. Generally, higher doses were linked to a higher incidence of MDs.ConclusionMDs were the most obvious adverse drug reactions in the nervous system triggered by using ASMs. Fourteen drugs exhibited positive signals for MDs, including some not previously reported. Conversely, 12 ASMs were deemed to have a lower possibility of inducing MDs. The incidence of MDs can be mitigated by selecting appropriate ASMs for epileptic patients. These findings enhance our understanding of the relationship between ASMs and MDs.

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supporting

confidence: 92%

mentioning

confidence: 99%

Movement disorders associated with antiseizure medications: A real‐world disproportionality analysis of the Food and Drug Administration Adverse Event Reporting System

Zhou

Wei

Chen

et al. 2023

Brit J Clinical Pharma

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“…Sáenz-Farret et al, reviewed the literature on movement disorders secondary to antiseizure medications. They found one manuscript of CNZ-induced tremor [ 119 ]. In a randomized controlled trial of adjunctive CNB in patients with uncontrolled focal seizures, tremor was reported by seven (6.2%) CNB users and by three (2.8%) individuals in the placebo group.…”

Section: Discussionmentioning

confidence: 99%

Cenobamate (YKP3089) and Drug-Resistant Epilepsy: A Review of the Literature

Rissardo,

Fornari Caprara

2023

Medicina

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Cenobamate (CNB), ([(R)-1-(2-chlorophenyl)-2-(2H-tetrazol-2-yl)ethyl], is a novel tetrazole alkyl carbamate derivative. In November 2019, the Food and Drug Administration approved Xcopri®, marketed by SK Life Science Inc., (Paramus, NJ, USA) for adult focal seizures. The European Medicines Agency approved Ontozry® by Arvelle Therapeutics Netherlands B.V.(Amsterdam, The Neatherlands) in March 2021. Cenobamate is a medication that could potentially change the perspectives regarding the management and prognosis of refractory epilepsy. In this way, this study aims to review the literature on CNB’s pharmacological properties, pharmacokinetics, efficacy, and safety. CNB is a highly effective drug in managing focal onset seizures, with more than twenty percent of individuals with drug-resistant epilepsy achieving seizure freedom. This finding is remarkable in the antiseizure medication literature. The mechanism of action of CNB is still poorly understood, but it is associated with transient and persistent sodium currents and GABAergic neurotransmission. In animal studies, CNB showed sustained efficacy and potency in the 6 Hz test regardless of the stimulus intensity. CNB was revealed to be the most cost-effective drug among different third-generation antiseizure medications. Also, CNB could have neuroprotective effects. However, there are still concerns regarding its potential for abuse and suicidality risk, which future studies should clearly assess, after which protocols should be changed. The major drawback of CNB therapy is the slow and complex titration and maintenance phases preventing the wide use of this new agent in clinical practice.

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“…In rare cases, parkinsonism cases were also reported in patients treated with lamotrigine [ 12 ]. No parkinsonism cases have yet been reported among patients treated with levetiracetam [ 13 ]. Indeed, this drug can also be used for the management of levodopa-induced dyskinesias in patients with Parkinson’s disease [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Antiepileptic Drugs and Incident Parkinson’s Disease among Patients Followed in German Primary Care Practices

Kostev

Doege²,

Jacob

et al. 2023

Brain Sciences

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Background: The aim of this study was to analyze whether prescriptions of antiepileptic drugs (AEDs) are significantly associated with an increased incidence of Parkinson’s disease (PD) in the German population. Methods: This study used data from German primary care practices found in the Disease Analyzer database (IQVIA) and included all patients aged ≥18 years who were diagnosed with PD between January 2010 and December 2021 (index date). The controls were patients without PD matched (1:1) by age, sex, and pre-diagnostic observation time in years. Associations between AED prescriptions (any AED as well as separate evaluations for carbamazepine, lamotrigine, levetiracetam, sodium valproate, gabapentin, and pregabalin) and subsequent diagnosis of PD were examined using a logistic regression model adjusted for epilepsy, restless legs syndrome, and neuropathy diagnoses. Results: We identified 24,950 cases that were matched with 24,950 controls (mean age 75.2 years, 47.3% women). Diagnoses of epilepsy, restless legs syndrome, and neuropathy as well as AED prescription were significantly associated with an increased incidence of PD. In the multivariate analysis, incidence of PD was significantly associated with epilepsy (OR: 1.91; 95% CI: 1.69–2.15), restless legs syndrome (OR: 3.02; 95% CI: 2.73–3.34), and neuropathy (OR: 1.53; 95% CI: 1.44–1.62)), as well as the prescription of any AED (OR: 1.43; 95% CI: 1.33–1.53), sodium valproate (OR: 2.39; 95% CI: 1.84–3.11), gabapentin (OR: 1.36; 95% CI: 1.22–1.52), and pregabalin (OR: 1.28; 95% CI: 1.15–1.41). Conclusion: Prescriptions of AEDs, including sodium valproate, gabapentin, and pregabalin, were associated with an increased risk of subsequent PD, even after adjustment for underlying diagnoses. Further studies are needed to confirm the present results.

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Antiseizure Drugs and Movement Disorders

Cited by 11 publications

References 203 publications

Movement disorders associated with antiseizure medications: A real‐world disproportionality analysis of the Food and Drug Administration Adverse Event Reporting System

Movement disorders associated with antiseizure medications: A real‐world disproportionality analysis of the Food and Drug Administration Adverse Event Reporting System

Cenobamate (YKP3089) and Drug-Resistant Epilepsy: A Review of the Literature

Association between Antiepileptic Drugs and Incident Parkinson’s Disease among Patients Followed in German Primary Care Practices

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