Laboratory monitoring in the pharmacotherapy of epilepsy

Fröscher, W.; Steinhoff, B. J.

doi:10.1007/s10309-010-0149-3

Cited by 5 publications

(3 citation statements)

References 53 publications

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“…Also, pharmacokinetic interactions of the administered AED were not recorded, as we did not measure the serum concentration of the AED on a regular base. In case of clobazam this should be insignificant, in case of phenobarbital a decrease of the serum concentration by enzyme inducing drugs, and a significant increase by valproic acid has to be considered [14]. In our opinion, this limitation does not influence the result of the study essentially.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, psychological variables of dependence, such as craving and loss of control, should not be an important issue in chronic users of benzodiazepines, barbiturates, or other substances, when taken to fight epilepsy. Physiological variables of dependence, that is, the development of tolerance to the anticonvulsant effect and withdrawal symptoms in patients with epilepsy, on the other hand, have been published extensively [13,14].…”

Section: Introductionmentioning

confidence: 99%

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Low Risk of Development of Substance Dependence for Barbiturates and Clobazam Prescribed as Antiepileptic Drugs: Results from a Questionnaire Study

Uhlmann¹,

Fröscher²

2009

CNS Neuroscience & Therapeutics

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There is no systematical research about the topic of dependence on antiepileptic drugs (AED) for patients with epilepsy, despite the fact that barbiturates and benzodiazepines comprise a potential risk of dependence. We hypothesize that there is no psychological substance dependence for patients with epilepsy, possibly because of their outcome expectations. The aim of the study was to examine these patients in terms of substance dependence. One hundred inpatients at the Lake Constance Epilepsy Center were asked about their experiences with AED in terms of dependence in a structured interview. We registered general statements about dependence of AED, markers for substance dependence, and outcome expectations. About 50% of the patients reported withdrawal symptoms and the development of tolerance, but less than 10% noticed loss of control and craving. Withdrawal symptoms and development of tolerance were significantly lower in a group of patients without barbiturates or clobazam versus patients with barbiturates or/and clobazam. There was no significant difference between these two groups in psychological criteria of dependence, that is, loss of control and craving. Outcome expectations of AED were clearly related to the efficacy against seizures, and only to a small amount to psychotropic effects. The study demonstrates that physiological variables of dependence are present more in patients with epilepsy with a permanent intake of barbiturates or clobazam, but psychological variables of dependence are rarely present in epileptic patients, with or without an intake of barbiturates and clobazam. These results confirm our hypothesis that substance dependence is not a major problem in benzodiazepines and barbiturates in patients with epilepsy. Outcome expectations seem to be related mainly to the anticonvulsant and not the psychotropic effect. This might be the reason for the absence of dependence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Low Risk of Development of Substance Dependence for Barbiturates and Clobazam Prescribed as Antiepileptic Drugs: Results from a Questionnaire Study

Uhlmann¹,

Fröscher²

2009

CNS Neuroscience & Therapeutics

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“…An in-vitro study indicated that VPA may displace TGB from protein binding [36] . This is most probably not clinically signifi cant, but may be of importance for the interpretation of (decreased) total TGB serum concentrations.…”

Section: Tiagabinementioning

confidence: 99%

Therapeutic drug monitoring of newer antiepileptic drugs / Therapeutic drug monitoring bei neueren Antiepileptika

Brandt¹,

May²

2011

LaboratoriumsMedizin

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Therapeutic drug monitoring (TDM) of antiepileptic drugs (AEDs) has been in clinical use for more than three decades. Its value has, however, been questioned recently for several reasons, e.g., the occurrence of newer AEDs, for which the use of TDM has to be evaluated, but also because of fi nancial strains on health systems. The current review aims at assessing the use of TDM in newer AEDs, i.e., those that entered the market since the beginning of the 1990s. As some have been licensed only recently and others are only in very limited use, either because of orphan drug status or because of limited effi cacy or potentially severe adverse events, only limited data exist for some of the newer AEDs. General considerations are made in the review, and each new AED is discussed, and, in some cases preliminary, assessment of the use of TDM is given.Therapeutic drug monitoring (TDM) bei Antiepileptika (AED) ist seit mehr als drei Jahrzehnten Bestandteil der klinischen Praxis. Die Berechtigung wird jedoch immer wieder in Frage gestellt, einerseits wegen der Zulassung zahlreicher neuer AED, f ü r die der Nutzen von TDM noch evaluiert werden muss, andererseits aber auch wegen fi nanzieller Einschnitte im Gesundheitswesen. Die vorliegende Ü bersicht soll den Nutzen von TDM bei neueren AED -also denjenigen AED, die seit dem Anfang der neunziger Jahre des 20. Jahrhunderts zugelassen wurden -darstellen. F ü r

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Laboruntersuchungen

Tilz¹,

Steinhoff²

2020

Epileptische Anfälle Und Epilepsien Im Erwachsenenalter

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Laboratory monitoring in the pharmacotherapy of epilepsy

Cited by 5 publications

References 53 publications

Low Risk of Development of Substance Dependence for Barbiturates and Clobazam Prescribed as Antiepileptic Drugs: Results from a Questionnaire Study

Low Risk of Development of Substance Dependence for Barbiturates and Clobazam Prescribed as Antiepileptic Drugs: Results from a Questionnaire Study

Therapeutic drug monitoring of newer antiepileptic drugs / Therapeutic drug monitoring bei neueren Antiepileptika

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