Adverse effects & drug load of antiepileptic drugs in patients with epilepsy: Monotherapy versus polytherapy.
TLDR
Polytherapy with combination of greater than or equal to three AEDs was associated with higher AEs and lower seizure control as compared to both monotherapy and combination of two AEDS.Abstract:
Background & objectives: Although the need for a combination of antiepileptic drugs (AEDs) in the treatment of epilepsy is well justified, but an associated increase in adverse effects (AEs) lends a restriction to polytherapy. The aim of this study was to evaluate AEs and drug load (prescribed daily dose/defined daily doses) of AEDs in patients with epilepsy (PWE). Methods: Consecutive PWEs attending Epilepsy clinic in a tertiary care hospital in New Delhi, India, were enrolled in the study. Demographic variables, such as age, gender, diagnosis, age at onset of seizures, frequency of seizures, use of all AEDs and adverse event profile (AEP) score were noted. Routine laboratory tests including lipid profile, fasting blood glucose, haematological parameters and liver and kidney function tests were done. Results: A total of 697 consecutive patients were included in this study. Of them, 64.4 per cent were male; mean age was 29.6 ± 10.6 yr. Generalized seizures and focal seizures were recorded in n=386 (55.4%) and n=311 (44.6%), respectively. Monotherapy and polytherapy with two and greater than or equal to three AEDs were prescribed in 264 (37.9%), 243 (34.9%) and 190 (27.2%) patients, respectively. The average AED load, duration of treatment as well as AEP score were found to be significantly higher in combination of greater than or equal to three AEDs as compared to both monotherapy and combination of two AEDs, whereas no significant difference was observed between monotherapy and combination of two AEDs. Patients on monotherapy were in good control of seizures as compared to polytherapy. There was no significant change in biochemical parameters between the groups. Interpretation & conclusions: Polytherapy with combination of greater than or equal to three AEDs was associated with higher AEs and lower seizure control as compared to both monotherapy and combination of two AEDs. AEs did not correlate with AED load, seizure type, gender and age of the patients but were associated with both numbers of AEDs as well as seizure frequency in PWE.read more
Citations
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Effectiveness and safety of perampanel as early add-on treatment in patients with epilepsy and focal seizures in the routine clinical practice: Spain prospective study (PERADON).
Javier Abril Jaramillo,José Carlos Estévez María,Juan Miguel Girón Úbeda,Óscar Vega López,María Elena Calzado Rivas,Hernando Pérez Díaz,Guillermina García Martín,Elena Vila Herrero,M. Chamorro-Muñoz,Francisco Vázquez,C. De la Fuente,L. Redondo,N. Peláez,Patricia Santágueda,Juan Jesús Rodríguez Uranga +14 more
TL;DR: Perampanel demonstrated a good efficacy and safety profile when used at a median dose of 6 mg/day, regardless of the combination with other AEDs, despite being shown to be effective as an adjunctive therapy for controlling refractory focal-onset seizures.
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TL;DR: A series of 17 newphenoxyacetamides has been prepared via multistep chemical synthesis as a continuation of the research carried out by the group on di- and tri-substituted phenoxyalkyl and phenoxyacetyl derivatives of amines, for example aminoalkanol or (un)modified amino acid moieties were introduced.
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Seizure recurrence risk in persons with epilepsy undergoing antiepileptic drug tapering
Sachin Kumar,Sudhir Chandra Sarangi,Manjari Tripathi,Bhargavi Ramanujam,Yogendra Kumar Gupta +4 more
TL;DR: Antiepileptic drug tapering in persons with epilepsy (PWE) after 2‐3 years of seizure freedom is still debatable because of the risk of seizure recurrence, but the correlation between them is found.
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Symptomatology of carbamazepine- and oxcarbazepine-induced hyponatremia in people with epilepsy.
Bianca Berghuis,Janic Hulst,Anja C M Sonsma,Mark McCormack,Gerrit-Jan de Haan,Josemir W. Sander,Dick Lindhout,Bobby P. C. Koeleman +7 more
TL;DR: In this paper, the adverse effects experienced by people taking carbamazepine or oxcarbazepine could be attributed to COIH, and adverse effects occurred in 65% of people with hyponatremia compared to 21% with normal sodium levels (odds ratio [OR] 7.5, P ≤.001).
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Acteoside Isolated from Colebrookea oppositifolia Smith Attenuates Epilepsy in Mice Via Modulation of Gamma-Aminobutyric Acid Pathways
Gollapalle Lakshminarayanashastry Viswanatha,H. Shylaja,Darisi Venkata Kishore,Marikunte V Venkataranganna,Nunna Bheema Lingeswara Prasad +4 more
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References
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TL;DR: The data suggest that suitable patients failing two AED regimens should be referred for epilepsy surgery, and those who do not attain long‐term seizure freedom with the first three treatment schedules are likely to have refractory epilepsy.
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Do antiepileptic drugs or generalized tonic-clonic seizure frequency increase SUDEP risk? A combined analysis.
Dale C. Hesdorffer,Torbjörn Tomson,Emma K. T. Benn,Josemir W. Sander,Lena Nilsson,Y. Langan,Thaddeus S. Walczak,Ettore Beghi,Martin J. Brodie,W. Allen Hauser +9 more
TL;DR: It was found that yearly frequency of generalized tonic–clonic seizures (GTCS) and antiepileptic drug (AED) polytherapy were associated with an increased risk for SUDEP.