Weight gain in children on oxcarbazepine monotherapy

Garoufi, Anastasia; Vartzelis, George; Tsentidis, Charalampos; Attilakos, Achilleas; Koemtzidou, Evangelia; Kossiva, Lydia; Katsarou, Eustathia; Soldatou, Alexandra

doi:10.1016/j.eplepsyres.2016.03.004

Cited by 20 publications

(15 citation statements)

References 33 publications

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“…Some children describe a negative impact on their body shape. Especially valproate [7] but also other anticonvulsant drugs such as oxcarbazepine [11] can cause weight gain. Fear of weight gain is especially present in young females [23].…”

Section: Burden Of Experienced Adesmentioning

confidence: 99%

How do pediatric patients perceive adverse drug events of anticonvulsant drugs? A survey

et al. 2020

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Anticonvulsant drugs have a high risk of adverse drug events. Little is known about the perception of those events by pediatric patients. We performed a survey in the neuropediatric departments of two university hospitals. Using a questionnaire, we interviewed patients aged 6-18 years with current anticonvulsant treatment regarding (i) their fears about potential adverse drug events, (ii) experienced adverse drug events, and (iii) perceived burden of experienced adverse drug events. One hundred patients took part in the interview. (i) 40 (40%) expressed fears that the medication could harm them. Eighteen of 40 (45%) named fears concerning specific adverse drug events. Of those, 12/18 (67%) feared neurologic or psychiatric symptoms. (ii) 37 (37%) of children described altogether 60 experienced adverse drug events. Of those, 38 (63%) concerned neurologic or psychiatric symptoms. (iii) 32/37 (82%) children who experienced adverse drug events felt bothered by the experienced event. Among others, they described an emotional burden (11/37, 30%), and restrictions in school performance (8/37, 22%) and favorite leisure activities (4/37, 11%). Conclusion: School-aged children are well able to describe adverse drug events of their anticonvulsant medication. Almost two thirds of the described events concern neurologic or psychiatric symptoms that cause an emotional burden and restrictions according to the patients. What is Known: • Anticonvulsants have a high potential of adverse drug events. • In an earlier survey, parents expressed fears of severe adverse drug events such as liver failure, which seldom occur, and reported a high number of neurological and psychological adverse drug events. What is New: • Many children fear that their anticonvulsants could harm them, and they fear and experience neurological and psychological adverse drug events. • According to the children, adverse drug events cause an emotional burden and restrictions in school performance and favorite leisure activities.

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Section: Burden Of Experienced Adesmentioning

confidence: 99%

How do pediatric patients perceive adverse drug events of anticonvulsant drugs? A survey

et al. 2020

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“…Carbamazepine preferentially binds to the voltage-gated sodium channel in neurons, blocks the sodium channel and stabilizes neuronal signaling by interfering with the secretion of neurotransmitters such as gamma-aminobutyric acid type A (GABAA) and glutamate [2,3,4]. In children with seizure disorder, the rate of overweight/obese subjects is significantly increased from 23% to 38.5% after carbamazepine treatment for 8 months at a concentration of 800 mg/day [5]. Carbamazepine treatment of 600–1000 mg/day for 8 weeks increases body weight from 14.6% to 22.4% in epileptic patients [6].…”

Section: Introductionmentioning

confidence: 99%

Carbamazepine Enhances Adipogenesis by Inhibiting Wnt/β-Catenin Expression

Kim

Chau

et al. 2019

Cells

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Carbamazepine is a drug that is widely used in the treatment of epilepsy and bipolar disorder. The prevalence of obesity in patients treated with carbamazepine has been frequently reported. However, whether carbamazepine affects adipogenesis, one of the critical steps in the development of obesity, remains unclear. Here, we show that carbamazepine increased the expression levels of peroxisome proliferator-activated receptor γ (PPARγ), CCAAT/enhancer-binding protein β (C/EBPβ), and fatty acid synthase (FASN) in 3T3-L1 cells. Notably, carbamazepine inhibited the expression levels of β-catenin, a negative regulator of adipogenesis, leading to enhanced adipogenesis. Conversely, β-catenin overexpression abolished the effect of carbamazepine on adipogenic gene expression. However, depletion of β-catenin further enhanced PPARγ expression. In addition, carbamazepine reduced β-catenin expression by lowering the levels of phospho-low density lipoprotein receptor-related protein 6 (p-LRP6) and phospho-glycogen synthase kinase 3β (p-GSK3β) in Wnt/β-catenin signaling. Moreover, carbamazepine reduced Wnt mRNA expression and decreased the promoter activities of TCF, the target of β-catenin during adipogenesis. These results suggest that carbamazepine enhances adipogenesis by suppressing Wnt/β-catenin expression, indicating its potential effects on obesity-related metabolism.

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“…Inhaled corticosteroid use in children with mild-to-moderate asthma leads to reduced height gain, with a trend toward greater reductions at higher doses (Loke et al 2015), and height deficits persist into adulthood (Childhood Asthma Management Program Research Group et al 2000; Kelly et al 2012). With the antiepileptic medications most commonly prescribed in the guanfacine cohort, valproate/valproic acid and oxcarbazepine, weight gain is a commonly reported concern (Verrotti et al 2009; Petty et al 2014; Hamed 2015; Garoufi et al 2016), and valproate has also been reported to reduce height gain (Lee et al 2013). The design of present analyses, however, meant that time-varying covariates, such as exposure to other medications, could not be included.…”

Section: Discussionmentioning

confidence: 99%

Weight and Height in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Longitudinal Database Study Assessing the Impact of Guanfacine, Stimulants, and No Pharmacotherapy

Schneider

Banaschewski

Feldman

et al. 2019

Journal of Child and Adolescent Psychopharmacology

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Objectives: To assess the impact of long-term pharmacotherapy with guanfacine immediate- or extended-release (GXR), administered alone or as an adjunctive to a stimulant, on weight and height in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Methods: Data were extracted from U.S. Department of Defense medical records for patients 4–17 years of age at index date (initiation of any study medication following a year without ADHD medications, or diagnosis if unmedicated) with weight/height measurements for the analysis period (January 2009–June 2013) and the previous year (baseline). Longitudinal weight and height z -scores were analyzed using multivariable regression in three cohorts: guanfacine (initial period of guanfacine exposure), first-line stimulant monotherapy (initial period of exposure), and unmedicated. Guanfacine cohort subgroups were based on previous/concurrent stimulant exposure. Results: The weight analyses included 47,910 patients (66.8% male) and the height analyses 41,248 (67.2% male). Mean initial exposure in the weight analyses was 237 days (standard deviation [SD] = 258, median = 142) for guanfacine and 257 days (SD = 284, median = 151) for first-line stimulant monotherapy, and was similar in the height analyses. Modeling indicated that guanfacine monotherapy was not associated with clinically meaningful deviations from normal z -score trajectories for weight (first-line, n = 943; nonfirst-line, n = 796) or height (first-line, n = 741; nonfirst-line, n = 644). In patients receiving guanfacine adjunctive to a stimulant, modeled weight ( n = 1657) and height ( n = 1343) z -scores followed declining trajectories. In this subgroup, mean standardized weight/height had decreased during previous stimulant monotherapy. For first-line stimulant monotherapy, modeled weight ( n = 32,999) and height ( n = 28,470) z -scores followed declining trajectories during year 1. In the unmedicated cohort, modeled weight ( n = 11,515) and height ( n = 10,050) z -scores were stable. Conclusions: Guanfacine monotherapy (first-line or nonfirst-line) was not associated with marked deviations from normal growth in this modeling study of children and adolescents with ADHD. In contrast, growth trajectories followed an initially declining course with stimulants, whether given alone or with adjunctive guanfacine.

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Weight gain in children on oxcarbazepine monotherapy

Cited by 20 publications

References 33 publications

How do pediatric patients perceive adverse drug events of anticonvulsant drugs? A survey

How do pediatric patients perceive adverse drug events of anticonvulsant drugs? A survey

Carbamazepine Enhances Adipogenesis by Inhibiting Wnt/β-Catenin Expression

Weight and Height in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Longitudinal Database Study Assessing the Impact of Guanfacine, Stimulants, and No Pharmacotherapy

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