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Clobazam and oxcarbazepine

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https://www.readbyqxmd.com/read/28943819/evaluation-of-safety-in-exceeding-maximum-adult-doses-of-commonly-used-second-generation-antiepileptic-drugs-in-pediatric-patients
#1
Mindl M Messinger, Sunita N Misra, Gary D Clark, Shannon M DiCarlo
OBJECTIVE: Pediatric patients often require larger doses of antiepileptic drug (AED) than adults in order to attain therapeutic serum concentrations and/or achieve seizure control. Safety and efficacy data are often extrapolated from adult literature; hence, optimal dosage may only be determined anecdotally or based on expert opinion. With limited pediatric dosing guidelines, milligrams per day that are based on weight may exceed the maximum adult dose. The primary objective of this study is to evaluate the safety of exceeding maximum doses as specified by the US Food and Drug Administration or manufacturers of commonly used AEDs in pediatric patients...
July 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28931473/psychiatric-and-behavioral-side-effects-of-antiepileptic-drugs-in-adults-with-epilepsy
#2
Baibing Chen, Hyunmi Choi, Lawrence J Hirsch, Austen Katz, Alexander Legge, Richard Buchsbaum, Kamil Detyniecki
PURPOSE: Psychiatric and behavioral side effects (PBSEs) are common, undesirable effects associated with antiepileptic drug (AED) use. The objective of the study was to compare the PBSE profiles of older and newer AEDs in a large specialty practice-based sample of patients diagnosed with epilepsy. METHODS: As part of the Columbia and Yale AED Database Project, we reviewed patient records including demographics, medical history, AED use, and side effects for 4085 adult patients (age: 18 years) newly started on an AED regimen...
September 17, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28857179/comparative-effectiveness-of-antiepileptic-drugs-in-patients-with-mesial-temporal-lobe-epilepsy-with-hippocampal-sclerosis
#3
COMPARATIVE STUDY
Ganna Androsova, Roland Krause, Mojgansadat Borghei, Merel Wassenaar, Pauls Auce, Andreja Avbersek, Felicitas Becker, Bianca Berghuis, Ellen Campbell, Antonietta Coppola, Ben Francis, Stefan Wolking, Gianpiero L Cavalleri, John Craig, Norman Delanty, Bobby P C Koeleman, Wolfram S Kunz, Holger Lerche, Anthony G Marson, Josemir W Sander, Graeme J Sills, Pasquale Striano, Federico Zara, Sanjay M Sisodiya, Chantal Depondt
OBJECTIVE: Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is a common epilepsy syndrome that is often poorly controlled by antiepileptic drug (AED) treatment. Comparative AED effectiveness studies in this condition are lacking. We report retention, efficacy, and tolerability in a cohort of patients with MTLE-HS. METHODS: Clinical data were collected from a European database of patients with epilepsy. We estimated retention, 12-month seizure freedom, and adverse drug reaction (ADR) rates for the 10 most commonly used AEDs in patients with MTLE-HS...
October 2017: Epilepsia
https://www.readbyqxmd.com/read/28815754/pharmacokinetic-interactions-and-dosing-rationale-for-antiepileptic-drugs-in-adults-and-children
#4
S C van Dijkman, W M Rauwé, M Danhof, O Della Pasqua
AIM: Population pharmacokinetic modelling has been widely used across many therapeutic areas to identify sources of variability, which are incorporated into models as covariate factors. Despite numerous publications on pharmacokinetic (PK) drug-drug interactions (DDIs) between antiepileptic drugs (AEDs), such data are not used to support the dose rationale for polytherapy in the treatment of epileptic seizures. Here we assess the impact of DDIs on plasma concentrations and evaluate the need for AED dose adjustment...
August 16, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28729328/comparative-safety-of-antiepileptic-drugs-for-neurological-development-in-children-exposed-during-pregnancy-and-breast-feeding-a-systematic-review-and-network-meta-analysis
#5
Areti Angeliki Veroniki, Patricia Rios, Elise Cogo, Sharon E Straus, Yaron Finkelstein, Ryan Kealey, Emily Reynen, Charlene Soobiah, Kednapa Thavorn, Brian Hutton, Brenda R Hemmelgarn, Fatemeh Yazdi, Jennifer D'Souza, Heather MacDonald, Andrea C Tricco
OBJECTIVES: Compare the safety of antiepileptic drugs (AEDs) on neurodevelopment of infants/children exposed in utero or during breast feeding. DESIGN AND SETTING: Systematic review and Bayesian random-effects network meta-analysis (NMA). MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched until 27 April 2017. Screening, data abstraction and quality appraisal were completed in duplicate by independent reviewers. PARTICIPANTS: 29 cohort studies including 5100 infants/children...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/27779771/efficacy-and-tolerability-of-antiepileptic-drugs-in-patients-with-focal-epilepsy-systematic-review-and-network-meta-analyses
#6
REVIEW
Marília Silveira de Almeida Campos, Lorena Rocha Ayres, Manuela Roque Siane Morelo, Fabiana Angelo Marques, Leonardo Régis Leira Pereira
Several newer antiepileptic drugs (AEDs) have been introduced into clinical practice, offering choices for individualizing the treatment of epilepsy since AEDs have different efficacy and tolerability profiles. In particular, questions exist regarding which AEDs are the best options for the monotherapy of focal epilepsy. Is carbamazepine (CBZ), which is considered the standard treatment for focal epilepsy, still the best option for monotherapy of focal epilepsy, despite the emergence of new AEDs? In this systematic review, we compared the relative tolerability of all available AEDs for monotherapy of all types of epilepsy as well as their efficacy in the monotherapy of focal epilepsy...
December 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27596103/current-treatment-options-for-early-onset-pediatric-epileptic-encephalopathies
#7
REVIEW
Rolla Shbarou
The management of early-onset, genetically determined epilepsies is often challenging. First-line anti-epileptic drugs (AEDs) often include phenobarbital, phenytoin, oxcarbazepine, carbamazepine, clonazepam, levetiracetam, and valproic acid. Combinations of medications are used in these patients with often intractable seizures, and they include topiramate, clobazam, felbamate, lacosamide, lamotrigine, rufinamide, vigabatrin, ACTH, oral steroids, and the ketogenic diet. Vagus nerve stimulator therapy offers some relief in selected patients...
October 2016: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/27264138/treatment-of-dravet-syndrome
#8
REVIEW
Elaine C Wirrell
Dravet syndrome is among the most challenging electroclinical syndromes. There is a high likelihood of recurrent status epilepticus; seizures are medically refractory; and patients have multiple co-morbidities, including intellectual disability, behaviour and sleep problems, and crouch gait. Additionally, they are at significant risk of sudden unexplained death. This review will focus predominantly on the prophylactic medical management of seizures, addressing both first-line therapies (valproate and clobazam) as well as second-line (stiripentol, topiramate, ketogenic diet) or later options (levetiracetam, bromides, vagus nerve stimulation)...
June 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/27184878/psychiatric-and-behavioural-disorders-in-children-with-epilepsy-ilae-task-force-report-adverse-cognitive-and-behavioural-effects-of-antiepileptic-drugs-in-children
#9
Albert Aldenkamp, Frank Besag, Giuseppe Gobbi, Rochelle Caplan, David W Dunn, Matti Sillanpää
The literature was evaluated for cognitive and more general behavioural effects. We distinguished the older antiepileptic drugs (AEDs), from the newer and newest AEDs. The striking finding was the lack of information on children. From the available evidence it would appear that there may be negative cognitive effects with phenobarbital, phenytoin, topiramate and zonisamide, and adverse behavioural effects with phenobarbital, valproate, gabapentin, topiramate, levetiracetam and zonisamide. There is inconclusive data on ethosuximide, clobazam, vigabatrin, felbamate, pregabalin, stiripentol, rufinamide, lacosamide and retigabine...
May 16, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/27038098/impact-of-perampanel-on-pharmacokinetics-of-concomitant-antiepileptics-in-patients-with-partial-onset-seizures-pooled-analysis-of-clinical-trials
#10
Oneeb Majid, Antonio Laurenza, Jim Ferry, Ziad Hussein
AIMS: To evaluate the impact of perampanel and demographics on clearance of concomitant antiepileptic drugs (AEDs), in patients with refractory partial-onset seizures. METHODS: Pooled data from three Phase III clinical studies with adjunctive perampanel were used. Blood samples for evaluation of 11 concomitant AEDs were taken during baseline (before perampanel initiation), and at weeks 10, 14, and 19 during the maintenance phase of perampanel treatment (2-12 mg/day, once daily at bedtime)...
August 2016: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/26984292/practice-update-review-of-anticonvulsant-therapy
#11
REVIEW
Derek J Chong, Andrew M Lerman
Since 2010, the Food and Drug Administration has approved the use of four new anti-epilepsy drugs (AEDs) for the treatment of epilepsy in the USA: clobazam (Onfi), ezogabine (Potiga), perampanel (Fycompa), and eslicarbazepine (Aptiom) as well as two extended release formulations, topiramate ER (Qudexy XR and Trokendi) and oxcarbazepine ER (Oxtellar). This not only provides practitioners ample choice to match medication profiles to their patients' preferences and co-morbidities better, but also challenges us to be proficient in the use of all...
April 2016: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/26908152/factors-influencing-topiramate-clearance-in-adult-patients-with-epilepsy-a-population-pharmacokinetic-analysis
#12
Eun-Kee Bae, Jongtae Lee, Jung-Won Shin, Jangsup Moon, Keon-Joo Lee, Yong-Won Shin, Tae-Joon Kim, Dongseong Shin, In-Jin Jang, Sang Kun Lee
PURPOSE: To identify the factors influencing topiramate pharmacokinetics (PK) in a large population of adult patients with epilepsy using population PK analysis. METHODS: Clinical data and blood samples were collected from 550 adult patients with epilepsy treated using topiramate. Nonlinear mixed effects modeling software (NONMEM, version 7.2) was used to fit the plasma concentration to a one-compartment PK model. Demographic and clinical variables tested as potential covariates were age, sex, body weight, height, serum creatinine, creatinine clearance (CLcr), total bilirubin, prothrombin time, albumin, aspartate transaminase (AST), alanine transaminase (ALT), daily dose (DOSE), and concomitant medications (phenytoin [PHT], clobazam, carbamazepine [CBZ], valproic acid, lamotrigine, levetiracetam, oxcarbazepine [OXC], pregabalin, clonazepam, and phenobarbital [PB])...
April 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/26896788/clinically-significant-pharmacokinetic-drug-interactions-of-antiepileptic-drugs-with-new-antidepressants-and-new-antipsychotics
#13
REVIEW
Edoardo Spina, Francesco Pisani, Jose de Leon
Antiepileptic drugs (AEDs) are frequently co-prescribed with new antidepressants (ADs) or new antipsychotics (APs). A PubMed search with no time limit was used to update the review of the clinically significant pharmacokinetic (PK) drug interactions DIs (DIs) between AEDs with new ADs and APs. Our best interpretation of what to expect regarding dosing changes in the average patient after combining AEDs with new ADs or new APs is summarized on updated tables that integrate the information on in vitro metabolism studies, therapeutic drug monitoring (TDM) studies, case report/series and prospective studies...
April 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/26751267/therapeutic-drug-monitoring-of-clobazam-and-its-metabolite-impact-of-age-and-comedication-on-pharmacokinetic-variability
#14
Margrete L Burns, Arton Baftiu, Mimi S Opdal, Svein I Johannessen, Cecilie Johannessen Landmark
BACKGROUND: Clobazam (CLB) has been used as an antiepileptic drug for several decades. There is still insufficient data regarding its pharmacokinetic variability in clinical practice. The purpose of this study was to investigate pharmacokinetic variability of CLB with emphasis on the impact of age and comedication in patients with epilepsy. METHODS: Serum concentration measurements of CLB and its metabolite N-desmethylclobazam (NCLB), as well as demographic and clinical data were retrieved from the routine therapeutic drug monitoring service at the National Center for Epilepsy, Norway, 2009-2013...
June 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/26224203/drug-metabolism-mechanism-knowledge-based-population-pharmacokinetic-approach-for-characterizing-clobazam-drug-drug-interactions
#15
RANDOMIZED CONTROLLED TRIAL
Dwain Tolbert, Ihor Bekersky, Hui-May Chu, Ene I Ette
A metabolic mechanism-based characterization of antiepileptic drug-drug interactions (DDIs) with clobazam in patients with Lennox-Gastaut syndrome (LGS) was performed using a population pharmacokinetic (PPK) approach. To characterize potential DDIs with clobazam, pharmacokinetic (PK) data from 153 patients with LGS in study OV-1012 (NCT00518713) and 18 healthy participants in bioavailability study OV-1017 were pooled. Antiepileptic drugs (AEDs) were grouped based on their effects on the cytochrome P450 (CYP) isozymes responsible for the metabolism of clobazam and its metabolite, N-desmethylclobazam (N-CLB): CYP3A inducers (phenobarbital, phenytoin, and carbamazepine), CYP2C19 inducers (valproic acid, phenobarbital, phenytoin, and carbamazepine), or CYP2C19 inhibitors (felbamate, oxcarbazepine)...
March 2016: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/25745819/the-effects-of-antiepileptic-inducers-in-neuropsychopharmacology-a-neglected-issue-part-i-a-summary-of-the-current-state-for-clinicians
#16
REVIEW
Jose de Leon
The literature on inducers in epilepsy and bipolar disorder is seriously contaminated by false negative findings. This is part i of a comprehensive review on antiepileptic drug (AED) inducers using both mechanistic pharmacological and evidence-based medicine to provide practical recommendations to neurologists and psychiatrists concerning how to control for them. Carbamazepine, phenobarbital and phenytoin, are clinically relevant AED inducers; correction factors were calculated for studied induced drugs. These correction factors are rough simplifications for orienting clinicians, since there is great variability in the population regarding inductive effects...
April 2015: Revista de Psiquiatrí́a y Salud Mental
https://www.readbyqxmd.com/read/25312999/modified-atkins-diet-may-reduce-serum-concentrations-of-antiepileptic-drugs
#17
M Kverneland, E Taubøll, K K Selmer, P O Iversen, K O Nakken
BACKGROUND: Modified Atkins diet is a treatment option for patients with pharmacoresistant epilepsy that is not suitable for surgery. In the last few years, we have tried dietary treatment added to antiepileptic drugs (AEDs) in adult patients with severe epilepsy. AIM OF THE STUDY: To examine a possible pharmacokinetic interaction between the modified Atkins diet and AEDs. METHODS: In four patients, AED serum concentrations were measured before onset and after 4 and 12 weeks on the diet...
March 2015: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/25196459/pharmacokinetic-and-pharmacodynamic-interactions-between-antiepileptics-and-antidepressants
#18
REVIEW
Domenico Italiano, Edoardo Spina, Jose de Leon
INTRODUCTION: Antiepileptic-antidepressant combinations are frequently used by clinicians; their pharmacokinetic (PK) and pharmacodynamic (PD) drug interactions (DIs) have not been well studied but are frequently likely to be clinically relevant. AREAS COVERED: This article provides a comprehensive review of PK DIs between antiepileptics and antidepressants. In the absence of PD DI studies, PD information on pharmacological mechanisms and studies on efficacy and safety of individual drugs are reviewed...
November 2014: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/25190506/comparison-of-antiepileptic-drugs-no-treatment-or-placebo-for-children-with-benign-epilepsy-with-centro-temporal-spikes
#19
REVIEW
Hui Jeen Tan, Jaspal Singh, Rajat Gupta, Christian de Goede
BACKGROUND: Benign Epilepsy with Centro Temporal Spikes (BECTS) is a common epilepsy syndrome with onset in childhood which almost always remits by adolescence. It is characterised by focal seizures associated with motor signs and somatosensory symptoms, at times progressing to become generalised. The characteristic interictal EEG shows normal background activity with centrotemporal spikes which are more prominent in sleep. The prognosis is good though subtle cognitive impairment has been implicated...
September 5, 2014: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/24925169/advances-in-anti-epileptic-drug-testing
#20
REVIEW
Matthew D Krasowski, Gwendolyn A McMillin
In the past twenty-one years, 17 new antiepileptic drugs have been approved for use in the United States and/or Europe. These drugs are clobazam, ezogabine (retigabine), eslicarbazepine acetate, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, perampanel, pregabalin, rufinamide, stiripentol, tiagabine, topiramate, vigabatrin and zonisamide. Therapeutic drug monitoring is often used in the clinical dosing of the newer anti-epileptic drugs. The drugs with the best justifications for drug monitoring are lamotrigine, levetiracetam, oxcarbazepine, stiripentol, and zonisamide...
September 25, 2014: Clinica Chimica Acta; International Journal of Clinical Chemistry
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