Variability and clinical relevance of the interaction between sodium valproate and carbamazepine in epileptic patients

Mckee, P. J. W.; Blacklaw, J.; Butler, Elaine; Gillham, R. A.; Brodie, MJ

doi:10.1016/0920-1211(92)90098-e

Cited by 35 publications

(14 citation statements)

References 28 publications

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“…A number of studies have indicated that valproate exerts little detrimental impact on cognitive function [Sun et al 2008;Donati et al 2007;McKee et al 1992;Gillham et al 1991]. However, a small minority of patients (5 of 364 adults in one study) can develop parkinsonism with associated memory problems and psychomotor slowing [Ristic et al 2006].…”

Section: Sodium Valproate and Ethosuximidementioning

confidence: 99%

The cognitive impact of antiepileptic drugs

Eddy¹,

Rickards²,

Cavanna³

2011

Ther Adv Neurol Disord

319

202

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Effective treatment of epilepsy depends on medication compliance across a lifetime, and studies indicate that drug tolerability is a significant limiting factor in medication maintenance. Available antiepileptic drugs (AEDs) have the potential to exert detrimental effects on cognitive function and therefore compromise patient wellbeing. On the other hand, some agents may serve to enhance cognitive function. In this review paper, we highlight the range of effects on cognition linked to a variety of newer and older AEDs, encompassing key alterations in both specific executive abilities and broader neuropsychological functions. Importantly, the data reviewed suggest that the effects exerted by an AED could vary depending on both patient characteristics and drug-related variables. However, there are considerable difficulties in evaluating the available evidence. Many studies have failed to investigate the influence of patient and treatment variables on cognitive functioning. Other difficulties include variation across studies in relation to design, treatment group and assessment tools, poor reporting of methodology and poor specification of the cognitive abilities assessed. Focused and rigorous experimental designs including a range of cognitive measures assessing more precisely defined abilities are needed to fill the gaps in our knowledge and follow up reported patterns in the literature. Longitudinal studies are needed to improve our understanding of the influence of factors such as age, tolerance and the stability of cognitive effects. Future trials comparing the effects of commonly prescribed agents across patient subgroups will offer critical insight into the role of patient characteristics in determining the cognitive impact of particular AEDs.

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Section: Sodium Valproate and Ethosuximidementioning

confidence: 99%

The cognitive impact of antiepileptic drugs

Eddy¹,

Rickards²,

Cavanna³

2011

Ther Adv Neurol Disord

319

202

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“…Par ailleurs, l'AVP semble inhiber la glucuronidation de la carbamazé pine-10,11-trans-diol, et probablement la conversion de la carbamazé pine-10,11-é poxyde, un mé tabolite ré actif hé patotoxique de la carbamazé pine, en un dé rivé trans-diol (McKee et al, 1992 ;Spina et al, 1996). Par consé quent, l'interaction entre l'AVP et la carbamazé pine est double, potentialisant l'hé patotoxicité des deux mé dicaments.…”

Section: Discussionunclassified

Relation entre les concentrations plasmatiques d’acide valproïque et la survenue d’une hépatotoxicité

et al. 2011

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“…One example of this type of interaction would be that of FBM and VPA upon CBZ-epoxide concentrations. In this setting, a patient receiving both FBM and CBZ or VPA and CBZ may experience substantial CNS adverse effects resembling CBZ intoxication, yet may have no substantial change in CBZ serum concentrations [53][54][55]. Effects on reactive metabolites has also been evoked as one explanation for the increased teratogenicity seen when some AEDs are used in combination.…”

Section: Hidden Interactionsmentioning

confidence: 96%

Drug interactions in epilepsy care: perspective on the newer generation antiepileptic drugs

Gidal¹,

Nemergut²,

French³

2002

Expert Review of Neurotherapeutics

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Pharmacokinetic interactions involving the antiepileptic drugs have long been considered to be an unavoidable component of epilepsy treatment. Many of the 'older' generation of antiepileptic drugs, including carbamazepine, phenytoin and phenobarbital, are recognized to cause hepatic induction of drug-metabolizing enzyme systems, such as the cytochrome P450 and UDP-gluculronyltransferase. Such interactions are not uncommonly implicated in resulting in clinically significant treatment complications. During the latter half of 1990s, a number of new antiepileptic drugs have become available to clinicians. Generally speaking, a common feature of these 'newer' generation medications are improved pharmacokinetic characteristics, including an improved drug interaction profile. The aim of this review is to summarize the data, both experimental and clinical, regarding pharmacokinetic interactions with the newer antiepileptic drugs.

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Variability and clinical relevance of the interaction between sodium valproate and carbamazepine in epileptic patients

Cited by 35 publications

References 28 publications

The cognitive impact of antiepileptic drugs

The cognitive impact of antiepileptic drugs

Relation entre les concentrations plasmatiques d’acide valproïque et la survenue d’une hépatotoxicité

Drug interactions in epilepsy care: perspective on the newer generation antiepileptic drugs

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