Choosing Among Antiepileptic Drugs

Fountain, Nathan B.

doi:10.1212/01.con.0000368235.64857.cf

Cited by 10 publications

(5 citation statements)

References 34 publications

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“…1,2 The goal of treatment of epilepsy includes minimizing the risk of recurrent seizures and antiepileptic drug (AED) side effects, and maintaining normal psychosocial and educational/vocational adjustment. 3 Adherence to AEDs is key to treatment success, one of the main causes of unsuccessful drug treatment for epilepsy is poor adherence to prescribed medication. 4,5 Non-adherence in children with epilepsy presents a potential ongoing challenge for achieving a key therapeutic goal of seizure control.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated with non-adherence to antiepileptic drugs among children with epilepsy in Jos, Nigeria

Ejeliogu¹,

Courage²

2020

Nig. J. Paed.

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Background: Childhood epilepsy causes a tremendous burden for the child, the family, society as well as the healthcare system. Adherence toantiepileptic drugs (AEDs) is key to treatment success, one of the main causes of unsuccessful treatment for epilepsy is poor adherence to medications. Nonadherence in children with epilepsy presents a potential ongoing challenge for achieving a key therapeutic goal of seizure control.Aim: To determine the prevalence and factors associated with nonadherence to AEDs among children with epilepsy at Jos University Teaching Hospital, Jos, Nigeria.Methodology: This cross sectional study was done to assess the prevalence and factors associated with non-adherence to AEDs among children with epilepsy from November 2019 to February 2020. A structured questionnaire was used to collect relevant information on the adherence of studysubjects to AEDs based on self/ caregiver report. Part of the questionnaire was derived from Morisky Medication Adherence Scale (MMAS-8).Results: One hundred and ninety four subjects were recruited for the study. The prevalence of nonadherence to AEDs was 44.8%. Factors significantly associated with non-adherence were low socioeconomic status, multiple drug therapy and long duration of treatment. The main reasons for nonadherence were financial constraint, forgetfulness, lack of improvement and medication side effects.Conclusion: Non-adherence to medication is common among children with epilepsy and it hampers the key therapeutic goal of seizure control. Improving per capita income of families, providing universal health insurance, medication reminders and appropriate education/counseling will reduce non-adherence and improve the long term outcome of childhood epilepsy in our region. Key words: Epilepsy, Children, Ant i -epilept ic drugs, Nonadherence, Prevalence, Associated factors, Jos, Nigeria.

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Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated with non-adherence to antiepileptic drugs among children with epilepsy in Jos, Nigeria

Ejeliogu¹,

Courage²

2020

Nig. J. Paed.

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“…EEG can also assist in the recommended choice of an antiepileptic drug for a patient. It has been established that antiepileptic drugs should be prescribed on the basis of the seizure pattern revealed through both clinic and EEG findings [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Imaging and Interictal Electroencephalography Findings in Newly Diagnosed Epileptic Children

Dirik

Şanlıdağ

2018

JCM

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Introduction: Epilepsy is one of the most frequently diagnosed chronic neurological disorders in children. Diagnosis is often based on seizure history and electroencephalography (EEG) assessment. Magnetic resonance imaging (MRI) is recommended for etiologic workup and intervention requirements. We aimed to detect by MRI if focal structural abnormalities are present in the brain in relation to interictal epileptiform discharges (IED). Material and Methods: The study was designed retrospectively. The data were collected from patients admitted to Near East University, Department of Pediatric Neurology, who were aged between 3 months and 18 years and who were diagnosed with epilepsy. The cases considered in the current study, however, were patients that had an EEG record prior to initiating treatment and an MRI within the first six months following diagnosis. Results: Among 222 patients, 212 (95.5%) had IED, and 92 (41.4%) had abnormal MRI results. The most frequently seen abnormalities detected by MRI were encephalomalacia, hydrocephaly, and atrophy. Among patients who had IED, the ones with multifocal IED were documented to have a statistically significant higher rate of abnormalities in MRI scans. In other patients, IED had no significant correlation with structural lesions detected by MRI. Conclusion: IED can be unrelated to MRI findings. Focal IED were not statistically concordant with the structural lesions detected by MRI. However, for the cases with multifocal discharges revealed by interictal EEG, the rate of abnormalities detected using MRI was 68%. Therefore, the likelihood of detecting abnormalities using MRI in patients with multifocal IED does support the necessity of the use of MRI in early diagnosis stages.

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“…Selection of an AED is dependent on several patient‐ and drug‐specific factors, some of which are related to the pharmacokinetic properties of the drug, such as dosing frequency, pharmacokinetics, interaction potential, and available formulations . Desirable pharmacokinetic characteristics of an AED include rapid and complete oral absorption, linear pharmacokinetics, longer half‐life, absence of active metabolites, absence of autoinduction properties, minimal induction or inhibition of principal drug‐metabolizing hepatic enzymes, rapid penetration through the blood–brain barrier and entry into the brain, low inter‐ and intrasubject variability, renal elimination, and low plasma protein binding …”

Section: Introductionmentioning

confidence: 99%

Advances in epilepsy treatment: lacosamide pharmacokinetic profile

Cawello

Stockis

Andreas

et al. 2014

Annals of the New York Academy of Sciences

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Lacosamide (LCM) is a functionalized amino acid specifically developed for use as an antiepileptic drug (AED) and is currently indicated as adjunctive treatment for partial-onset seizures in adults with focal epilepsy (maximum approved dose 400 mg/day). Characterization of the pharmacokinetic profile is an important aspect in the development of LCM. Studies in healthy subjects and in patients with focal epilepsy have established that LCM has several favorable pharmacokinetic characteristics, including rapid absorption and high oral bioavailability not affected by food, linear and dose-proportional pharmacokinetics, low inter- and intraindividual variability, low plasma protein binding, renal elimination, and a low potential for clinically relevant pharmacokinetic drug-drug interactions both with AEDs and other common medications. Studies have demonstrated bioequivalence among the three LCM formulations (oral tablets, oral solution, and solution for intravenous (IV) infusion), allowing direct conversion to or from oral and IV administration without titration. Thus, the favorable and predictable pharmacokinetic profile and bioequivalence of LCM formulations, coupled with the low potential for clinically relevant pharmacokinetic drug-drug interactions, make LCM an easy-to-use adjunctive treatment for the management of patients with focal epilepsy.

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Choosing Among Antiepileptic Drugs

Cited by 10 publications

References 34 publications

Prevalence and factors associated with non-adherence to antiepileptic drugs among children with epilepsy in Jos, Nigeria

Prevalence and factors associated with non-adherence to antiepileptic drugs among children with epilepsy in Jos, Nigeria

Magnetic Resonance Imaging and Interictal Electroencephalography Findings in Newly Diagnosed Epileptic Children

Advances in epilepsy treatment: lacosamide pharmacokinetic profile

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