Effect of reduction of anticonvulsants on wellbeing.

Fischbacher, E.

doi:10.1136/bmj.285.6339.423

Cited by 62 publications

(32 citation statements)

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“…In any policy of substitution and reduction of anticonvulsant polypharmacy there is a risk ofexacerbating seizures (Shorvon & Reynolds, 1979), particularly if barbiturates are to be withdrawn (Fischbacher, 1982). The best approach to transition is poorly defined and in this preliminary study we did not find deterioration of control even over a 1 week period of withdrawal (Cases 1 and 2).…”

Section: Discussionmentioning

confidence: 53%

Carbamazepine substitution in severe partial epilepsy: implication of autoinduction of metabolism

Macphee¹,

Brodie²

1985

Postgraduate Medical Journal

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Summary:Established partial seizures are often refractory to treatment and many patients receive polypharmacy. An attempt was made to improve seizure control with the substitution of carbamazepine (CBZ) for existing treatment in 7 consecutive unremitting cases of partial epilepsy referred by their physicians as 'intractable'. This produced a significant improvement in control of partial (P < 0.02) and secondary generalized (P < 0.01) seizures, with 5 patients experiencing a 50% or greater reduction in seizure frequency. A single patient suffered a generalized seizure during the period of changeover. In 3 cases auto-induction of CBZ metabolism resulted in temporary loss of seizure control which was restored by an increase in dose. A policy of planned substitution of CBZ in partial epilepsy previously regarded as intractable may be successful in selected patients. The possible deleterious effect of CBZ auto-induction should be anticipated.

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Section: Discussionmentioning

confidence: 53%

Carbamazepine substitution in severe partial epilepsy: implication of autoinduction of metabolism

Macphee¹,

Brodie²

1985

Postgraduate Medical Journal

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“…Ovakav ishod obustave AET ne se može predvideti [7]. Kod 19-23% bolesnika se, pri ponovnom uvođenju AET, ne uspostavlja kontrola epileptičnih napada koja je adekvatna postignutoj kontroli pre obustavljanja AET [8][9][10].…”

Section: Uvodunclassified

Fear of having the antiepileptic drug withdrawn

Pogancev

2011

Med pregl

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“…It is known that the reduction of one or more AED is possible without an increase in seizure frequency [5][6][7] . Moreover, AEDs may aggravate pre-existing seizures and trigger new seizure types 8 .…”

Section: Palavras-chave: Epilepsia Infância Droga Antiepiléptica Tmentioning

confidence: 99%

First, do no harm: the risks of overtreating children with epilepsy

Chuang

Guerreiro

Tsuchie

et al. 2007

Arq. Neuro-Psiquiatr.

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BACKGROUND: Although overtreatment with antiepileptic drugs contributes to the morbidity associated with epilepsy, many children still are overtreated. OBJECTIVE: To evaluate if the withdrawal of at least one antiepileptic drug (AED) in children with refractory epilepsy using polytherapy enable a better seizure control. METHOD: This was a prospective study. Children with refractory epilepsy using at least two AEDs were included. Once the patient, or guardian, agreed to participate in the study, one or more AED were slowly tapered off. The remaining AEDs dosages could be adjusted as needed, but a new AED could not be introduced. RESULTS: Fifteen patients were evaluated, three girls; ages ranging from 3 to 18 (mean=8.7 years). After at least one AED withdrawal, two (13.5%) patients became seizure free, seizures improved >50% in 5 (33.5%) patients, did not change in 5 (33.5%), and seizure frequency became worse in 3 (20%). Adverse events improved in 12 patients (80%). CONCLUSION: The withdrawal of at least one AED is a valuable option in the treatment of selected children with refractory epilepsy.

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Effect of reduction of anticonvulsants on wellbeing.

Cited by 62 publications

References 1 publication

Carbamazepine substitution in severe partial epilepsy: implication of autoinduction of metabolism

Carbamazepine substitution in severe partial epilepsy: implication of autoinduction of metabolism

Fear of having the antiepileptic drug withdrawn

First, do no harm: the risks of overtreating children with epilepsy

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