Haematological Aspects during Treatment with Anticonvulsant Drugs

Vries, S.I. de

doi:10.1111/j.1528-1157.1965.tb03345.x

Cited by 14 publications

(3 citation statements)

References 47 publications

(19 reference statements)

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“…[47][48][49][50] Early investigators suggested monitoring blood levels, hematology, serum chemistry, and urinalysis to identify the patient at risk. 51 These practices became standard recommendations; they appear in the United States Physicians' Desk Reference 1 and the Canadian Compendium of Pharmaceutical and Specialties 52 and are considered the medicolegal "standard of practice." However, scientific evidence does not support routine monitoring since laboratory studies rarely predict the occurrence of serious drug reactions.…”

Section: Studies Ofmentioning

confidence: 99%

Divalproex Sodium in Headache: Literature Review and Clinical Guidelines

Silberstein¹

1996

Headache

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Divalproex sodium is an anticonvulsant agent approved for use either alone or in combination with other antiepileptic drugs for simple and complex absences seizures and mania. Four double-blind placebo-controlled studies have confirmed that divalproex sodium/valproate is an effective migraine treatment. In all of the clinical studies, whether open, retrospective, or placebo-controlled and double-blind, valproate was an effective preventive treatment for migraine. There was a reduction in the number of migraine attacks, and migraine duration and intensity were also reduced in some instances. It is equally as effective in patients with severe frequent migraines as in those with less severe migraines. In clinical trials, the most frequent adverse events reported by patients treated with divalproex sodium were nausea, asthenia, dyspepsia, dizziness, somnolence, and diarrhea, with most adverse events being mild to moderate in severity.

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Section: Studies Ofmentioning

confidence: 99%

Divalproex Sodium in Headache: Literature Review and Clinical Guidelines

Silberstein¹

1996

Headache

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“…The phenobarbital hypersensitivity reaction was reported in 1953 (Mcgreachy & Bloomer, 1953). Agranulocytosis was reported in 1937 (Plum, 1937), but by then the risks of blood dyscrasias and marrow aplasia were known to be lower on barbiturate than on phenytoin; most authorities therefore considered the drug “safe” in this respect (De Vries, 1965). The first association with megaloblastic anemia was noted in 1956 (Hawkings & Meynell, 1958) and this was more fully elucidated by Chanarin et al.…”

Section: Side Effectsmentioning

confidence: 99%

How phenobarbital revolutionized epilepsy therapy: The story of phenobarbital therapy in epilepsy in the last 100 years

Yasiry

Shorvon

2012

Epilepsia

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Summary Phenobarbital (phenobarbitone) was first used as an antiepileptic drug 100 years ago, in 1912. This article tells the story of the discovery of its antiepileptic action, its early development, and the subsequent course of its clinical use over the 100‐year period. The side effects, pharmacokinetics, and misuse of barbiturates are considered, along with the more recent clinical trials and the drug’s current clinical utilization. The introduction of controlled drug regulations, the comparative cost of phenobarbital, and its inclusion on the World Health Organization (WHO) essential drug list are discussed. It is one of the few drugs on the formulary in 1912 that is still listed today, and remarkably its efficacy in epilepsy has not been significantly bettered. The current recommendation by the WHO is that phenobarbital should be offered as the first option for therapy for convulsive epilepsy in adults and children if availability can be ensured. This is rated as a strong recommendation because of the proven efficacy and low cost of phenobarbital, and despite its perceived side‐effect profile and the practical problems of access. Whether this recommendation puts “a hierarchy on the brain,” as has been suggested, is arguable. Much still needs to be learned about the drug’s effects, and the issues raised by phenobarbital have lessons for all antiepileptic drug therapy.

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“…A number of open‐label studies of routine screening have been performed for specific AEDs (6,8,9). In 1986, we reported the lack of value of routine screening of blood and urine in a prospective study of 199 children (6).…”

Section: Acute Severe Reactionsmentioning

confidence: 99%

Monitoring for Adverse Effects of Antiepileptic Drugs

Camfield

2006

Epilepsia

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Summary:Best practices for monitoring the adverse effects of antiepileptic drugs (AEDs) have not been carefully studied. Routine blood and urine studies do not appear to be of value in asymptomatic patients to avoid severe acute reactions. Subtle chronic AED side effects exist but algorithms for their detection and treatment are not well developed. Randomized clinical trials do not support the value of routine AED serum levels to improve compliance, seizure control, or avoid side effects. Simple screening procedures for neurotoxicity have not been developed. Some personal suggestions are offered.

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Haematological Aspects during Treatment with Anticonvulsant Drugs

Cited by 14 publications

References 47 publications

Divalproex Sodium in Headache: Literature Review and Clinical Guidelines

Divalproex Sodium in Headache: Literature Review and Clinical Guidelines

How phenobarbital revolutionized epilepsy therapy: The story of phenobarbital therapy in epilepsy in the last 100 years

Monitoring for Adverse Effects of Antiepileptic Drugs

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