Use of oxcarbazepine for treatment of refractory status epilepticus

Kellinghaus, Christoph; Berning, Sascha; Stögbauer, Florian

doi:10.1016/j.seizure.2013.11.002

Cited by 20 publications

(18 citation statements)

References 12 publications

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“…45 Use of oral oxcarbazepine in SE was reported in 13 patients with a median treatment latency of 81 hours. 46 Oxcarbazepine was the last drug in eight patients (62%); however, hyponatremia was seen in three of these individuals. 46 With regard to treatment-emergent adverse effects, our study contradicts the results reported by several other authors [27][28][29][30] who did not observe any adverse effects.…”

Section: Discussionmentioning

confidence: 98%

“…46 Oxcarbazepine was the last drug in eight patients (62%); however, hyponatremia was seen in three of these individuals. 46 With regard to treatment-emergent adverse effects, our study contradicts the results reported by several other authors [27][28][29][30] who did not observe any adverse effects. In our study, hyperammonemia was present in 38 patients (35.8%), with a trend toward higher levels of ammonia in patients who received concurrent treatment with VPA and PB.…”

Section: Discussionmentioning

confidence: 98%

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Treatment of refractory and superrefractory status epilepticus with topiramate: A cohort study of 106 patients and a review of the literature

et al. 2019

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Objective: Novel treatments are needed to control treatment-resistant status epilepticus (SE). We present a summary of clinical cases where oral topiramate (TPM) was used in refractory SE (RSE) and superrefractory SE (SRSE). Methods: A review of medical records was carried out to detect TPM administration in SE patients treated in Frankfurt and Marburg between 2011 and 2016. The primary outcome question concerned SE resolution after TPM initiation. Results: In total, TPM was used in 106 of 854 patients having a mean age of 67.4 ± 18.1 years, 61 of whom were female (57.5%). The median latency from SE onset to TPM initiation was 8.5 days. Patients with SE had previously failed a median of five other antiepileptic drugs. The median initial TPM dose was 100 mg/d, which was uptitrated to a median maintenance dose of 400 mg/d. Treatment with TPM was continued for a median time of 12 days. TPM was the last drug provided to 42 of 106 (39.6%) patients, with a resultant response attributed to TPM observed in 29 of 106 (27.4%) patients. A response was attributed to TPM in 21 (31.8%) of 66 RSE cases and eight (20%) of 40 SRSE cases. Treatment-emergent adverse events were attributed to TPM usage in two patients, one each with pancreatitis and hyperchloremic acidosis, and in 38 patients (35.8%), hyperammonemia was seen. Thirty-four of these patients received a combination of TPM and valproate and/or phenobarbital.The intrahospital mortality rate was 22.6% (n = 24). Significance: The rate of SE cessation attributed to TPM treatment (27.4%) represents a relevant response given the late treatment position of TPM and the treatment latency of more than 8 days. Based on these results and in line with the findings of other case series, TPM can be considered an alternative option for treating RSE and SRSE.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Treatment of refractory and superrefractory status epilepticus with topiramate: A cohort study of 106 patients and a review of the literature

et al. 2019

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“…Both carbamazepine and oxcarbazepine (a derivate of the former) are known to cause hyponatremia with an occurrence of 4.8-31.3% and 0.14-73.3%, respectively [7,[13][14][15][16][17][18]. In our study, chronic use of oxcarbazepine was associated with the highest risk of hospitalization due to hyponatremia.…”

Section: Discussionmentioning

confidence: 46%

Differences in associations of antiepileptic drugs and hospitalization due to hyponatremia: A population–based case–control study

Falhammar

Lindh

Calissendorff

et al. 2018

Seizure

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There was a strong association between newly initiated treatment with carbamazepine, oxcarbazepine and levetiracetam, and hospitalization due to hyponatremia. The corresponding association for phenytoin and valproate was moderate. The risk for hyponatremia was lower during ongoing treatment. Lamotrigine and gabapentin had the lowest risk both during initiation and ongoing treatment and may be advantageous in patients at risk of developing hyponatremia.

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“…There is approximately a 25-30% chance of cross-reactivity between carbamazepine and oxcarbazepine. Number of cases of hyponatremia have been recorded with this treatment and with greater strength of association [49,84,90,92,98,99].…”

Section: Oxcarbazepinementioning

confidence: 99%

Hyponatremia and Psychotropic Drugs

Cortés¹,

Muñoz²

2019

Fluid and Electrolyte Disorders

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Given the widespread use of psychotropic drugs in the population, it's important to consider hyponatremia as an avoidable and reversible adverse effect and include the detection of high-risk subjects to establish safer medications, as well as early detection measures in routine clinical practice. Although hyponatremia has been especially associated with serotonergic antidepressants (SSRIs), there is also an elevated risk with tricyclics, duals and heterocyclic antidepressants, due to the different mechanisms of action at the renal tubular level and the release of ADH. Hyponatremia secondary to tricyclics with slow CYP2D6 metabolizers have higher plasma concentrations of antidepressants metabolized by CYP2D6. Hyponatremia secondary to SSRIs appears in the first week of treatment, it is "not dose-dependent" and normalization of natremia occurs between 2 and 20 days after stopping the medication. Bupropion, trazodone, mianserin, reboxetine and agomelatine are a safe alternative. Also antiepileptics have been related to hyponatremia. Both typical and atypical antipsychotics have been exposed to an increased risk of hyponatremia, even after adjusted factors such as age, sex and comorbidity. Other factors that favor the onset of hyponatremia act synergistically with psychotropic drugs, such as: advanced age, female sex, concomitant diuretic intake, low body weight and low sodium levels; NSAID, ACEIs, and warm.

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Use of oxcarbazepine for treatment of refractory status epilepticus

Abstract: OXC could be used for refractory SE under close electrolyte monitoring when standard agents fail or are unsuitable.

Cited by 20 publications

References 12 publications

Treatment of refractory and superrefractory status epilepticus with topiramate: A cohort study of 106 patients and a review of the literature

Treatment of refractory and superrefractory status epilepticus with topiramate: A cohort study of 106 patients and a review of the literature

Differences in associations of antiepileptic drugs and hospitalization due to hyponatremia: A population–based case–control study

Hyponatremia and Psychotropic Drugs

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