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anti-epileptic drug

U C Wieshmann, G Baker
OBJECTIVE: To ascertain efficacy and tolerability of carbamazepine (CBZ), sodium valproate (VPA), lamotrigine (LTG) and levetiracetam (LEV) using the UKAED register ( METHODS: Patients on CBZ (n=91), VPA (n=61), LTG (n=105), LEV (n=72) and healthy control subjects (CTR) on no medication (n=51) were extracted. All patients had anonymously provided information on seizure type and frequency and completed the Liverpool Adverse Event Profile (LAEP). RESULTS: The number of seizure-free patients in the last 4 weeks was overall CBZ/VPA/LTG/LEV=60%/79%/67%/67%, for generalized epilepsy was CBZ/VPA/LTG/LEV=67%/89%/65%/94%, and for localization-related epilepsy was CBZ/VPA/LTG/LEV=59%/71%/67%/57%...
October 18, 2016: Acta Neurologica Scandinavica
Emma Suggett, John Marriott
BACKGROUND: A number of methods exist for the risk assessment of hospital inpatients to determine the likelihood of patients experiencing drug-related problems (DRPs), including manual review of a patient's medication (medication reviews) and more complex electronic assessment using decision support alerts in electronic prescribing systems. A systematic review was conducted to determine the evidence base for potential risks associated with adult hospital inpatients that could not only lead to medication-related issues but might also be directly associated with pharmacist intervention...
September 2016: Drugs—Real World Outcomes
Rachel Mourot-Cottet, Frédéric Maloisel, François Séverac, Olivier Keller, Thomas Vogel, Martine Tebacher, Jean-Christophe Weber, Georges Kaltenbach, Jacques-Eric Gottenberg, Bernard Goichot, Jean Sibilia, Anne-Sophie Korganow, Raoul Herbrecht, Emmanuel Andrès
BACKGROUND: Little data is currently available in the literature on neutropenia and agranulocytosis in the elderly, and, to our knowledge, idiosyncratic drug-induced agranulocytosis is particularly poorly covered, or not at all. OBJECTIVE: We herein describe the clinical picture and outcome of patients aged ≥75 years with established idiosyncratic drug-induced agranulocytosis. PATIENTS AND METHODS: Data from 61 patients over 75 years old with idiosyncratic drug-induced agranulocytosis were retrospectively reviewed...
September 5, 2016: Drugs—Real World Outcomes
Chandni Prakash, Susan Hatters-Friedman, Charmian Moller-Olsen, Abigail North
INTRODUCTION: Pregnancy is a vulnerable period for recurrence of bipolar disorder. Discontinuation of mood stabilisers during pregnancy and the postpartum period can significantly increase the risk of recurrence of bipolar disorder. Lamotrigine is an anti-epileptic drug that has been approved for the maintenance treatment of bipolar disorder. Epilepsy literature has indicated that lamotrigine has a reassuring safety profile in pregnancy but there is little information on its effectiveness and safety in pregnant women with mental disorders...
August 15, 2016: Psychopharmacology Bulletin
A Loughman, N A Bendrups, W J D'Souza
Psychiatric disorders and associated poor psychosocial outcomes are recognised to be a common sequelae of epilepsy. The extent to which this is true of genetic generalised epilepsies (GGE), particularly syndromes other than juvenile myoclonic epilepsy (JME) is unclear. This systematic review synthesises findings regarding psychiatric and associated comorbidities in adults and children with GGE. Systematic review yielded 34 peer-reviewed studies of psychiatric and psychosocial outcomes in adults and children with GGE...
October 10, 2016: Neuropsychology Review
Rizwana Rehman, Amanda Everhart, Alfred T Frontera, Pamela R Kelly, Maria Lopez, Denise Riley, Sheela Sajan, David M Schooff, Tung T Tran, Aatif M Husain
Identification of epilepsy patients from administrative data in large managed healthcare organizations is a challenging task. The objectives of this report are to describe the implementation of an established algorithm and different modifications for the estimation of epilepsy prevalence in the Veterans Health Administration (VHA). For the prevalence estimation during a given time period patients prescribed anti-epileptic drugs and having seizure diagnoses on clinical encounters were identified. In contrast to the established algorithm, which required inclusion of diagnoses data from the time period of interest only, variants were tested by considering diagnoses data beyond prevalence period for improving sensitivity...
September 23, 2016: Epilepsy Research
Md Asiful Islam, Fahmida Alam, Mohammad Amjad Kamal, Kah Keng Wong, Teguh Haryo Sasongko, Siew Hua Gan
Neurological manifestations or disorders associated with central nervous system (CNS) are one of the most common as well as important clinical characteristics of antiphospholipid syndrome (APS). Although in the last updated (2006) classification criteria of APS its neurological manifestations encompassed only transient ischemic attack (TIA) and stroke, diverse 'non-criteria' neurological disorders or manifestations (headache, migraine, bipolar disorder, transverse myelitis, dementia, chorea, epileptic seizures, multiple sclerosis, psychosis, cognitive impairment, Tourette's syndrome, parkinsonism, dystonia, transient global amnesia, obsessive compulsive disorder and leukoencephalopathy) have been observed in APS patients...
September 20, 2016: CNS & Neurological Disorders Drug Targets
Edward K Avila, Marc Chamberlain, David Schiff, Jaap C Reijneveld, Terri S Armstrong, Roberta Ruda, Patrick Y Wen, Michael Weller, Johan A F Koekkoek, Sandeep Mittal, Yoshiki Arakawa, Ali Choucair, Jorge Gonzalez-Martinez, David R MacDonald, Ryo Nishikawa, Aashit Shah, Charles J Vecht, Paula Warren, Martin J van den Bent, Lisa M DeAngelis
Patients with low-grade glioma frequently have brain tumor-related epilepsy, which is more common than in patients with high-grade glioma. Treatment for tumor-associated epilepsy usually comprises a combination of surgery, anti-epileptic drugs (AEDs), chemotherapy, and radiotherapy. Response to tumor-directed treatment is measured primarily by overall survival and progression-free survival. However, seizure frequency has been observed to respond to tumor-directed treatment with chemotherapy or radiotherapy...
September 20, 2016: Neuro-oncology
Samia A Nour, Nevine S Abdelmalak, Marianne J Naguib, Hassan M Rashed, Ahmed B Ibrahim
Clonazepam (CZ) is an anti-epileptic drug used mainly in status epilepticus (SE). The drug belongs to Class II according to BCS classification with very limited solubility and high permeability and it suffers from extensive first-pass metabolism. The aim of the present study was to develop CZ-loaded polymeric micelles (PM) for direct brain delivery allowing immediate control of SE. PM were prepared via thin film hydration (TFH) technique adopting a central composite face-centered design (CCFD). The seventeen developed formulae were evaluated in terms of entrapment efficiency (EE), particle size (PS), polydispersity index (PDI), zeta potential (ZP), and in vitro release...
September 20, 2016: Drug Delivery
Charlotte Laurent, Jean Capron, Bluenn Quillerou, Guy Thomas, Sonia Alamowitch, Olivier Fain, Arsène Mekinian
BACKGROUND: Steroid-responsive encephalopathy and associated autoimmune thyroiditis (SREAT) is characterized by encephalopathy and the presence of antithyroid antibodies. We describe the clinical presentation, outcome and treatments for SREAT by a systematic review of the literature. METHODS: MEDLINE via PubMed, Web of Science and the Cochrane Library were searched for articles published until 2015. Inclusion criteria were unexplained encephalopathy with antithyroid antibodies...
September 15, 2016: Autoimmunity Reviews
P V Mazin, I V Sheshunov, Yu V Kislitsyn, N K Mazina
AIM: Meta-analysis was undertaken to evaluate rufinamide safety and effectiveness in numerous heterogeneous groups of patients with severe and drug resistant epileptic disorders. MATERIAL AND METHODS: There were 164 relevant articles available via medico-clinical periodic databases, but only 15 have been chosen suitable for meta-analysis. All together 1847 participants were included into common massive, with Lennox-Gastaut syndrome (LGS) and similar encephalopathy syndromes, and with drug-resistant partial epileptic forms...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Paul V Motika, David C Spencer
The treatment of epilepsy in older individuals is an increasingly important topic in neurology and an area that all treating neurologists should have familiarity with. As the population ages, the number of patients over 65 who present with new-onset epilepsy will increase, as will the complexity of their comorbid medical and neurological disorders. In older patients, seizures are often unwitnessed, or present with atypical symptoms, making the diagnosis more challenging. Additionally, there are relatively limited data to guide the use of anti-epileptic medications and other treatments in this patient population...
November 2016: Current Neurology and Neuroscience Reports
Davor Kin-Fan Chau, Angus Yiu-Ting Choi, Wen Yang, Wing Nang Leung, Chun Wai Chan
The etiology of Autism Spectrum Disorder (ASD) remains controversial. Deficits in social communication are one of the key criteria for ASD diagnosis. Valproic acid (VPA), which is an anti-epileptic and anti-depressive drug, is one of the teratogens to cause ASD onset. Moreover, synaptic dysfunction is suggested as one of the major causative factor in VPA-induced ASD in vitro and in vivo studies. Herein, this study aimed to determine the excitatory/inhibitory synaptic mRNA and protein expression in VPA-induced autistic mice...
January 1, 2017: Behavioural Brain Research
Kamini Marathe, Nevin McVicar, Alex Li, Miranda Bellyou, Susan Meakin, Robert Bartha
Reversal of the intracellular/extracellular pH gradient is a hallmark of malignant tumors and is an important consideration in evaluating tumor growth potential and the effectiveness of anticancer therapies. Glioblastoma multiforme (GBM) brain tumors have increased expression of the carbonic anhydrase (CA) isozymes CAII, CAIX and CAXII that contribute to the altered regulation of intracellular pH (pHi). The anti-epileptic drug topiramate (TPM) inhibits CA action and may acidify the tumor intracellular compartment...
September 9, 2016: Journal of Neuro-oncology
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
Ying Xu, Dennis Nguyen, Armin Mohamed, Cheryl Carcel, Qiang Li, Mansur A Kutlubaev, Craig S Anderson, Maree L Hackett
PURPOSE: To determine the frequency of false positive diagnoses of epilepsy and to explore its imitators and consequences. METHOD: A systematic review of all published observational studies (to November 2015) was conducted to determine the proportion of false positive diagnoses of epilepsy. We included studies of people of all ages receiving a diagnosis of epilepsy. All observational study designs were included with the exception of case-reports and case series with fewer than 3 participants...
October 2016: Seizure: the Journal of the British Epilepsy Association
Malin Schöpper, Albert C Ludolph, Susanne Fauser
INTRODUCTION: The current study assessed the knowledge and attitudes of dentists and neurologists, and of their patients with epilepsy, in the catchment area of an outpatient clinic for epilepsy in southern Germany. METHODS: One-hundred patients with epilepsy were asked to complete questionnaires about their dental treatment. Attitudes of their attending dentists and neurologists were also assessed. RESULTS: Patients with epilepsy: The questionnaires were returned by 82% of patients...
September 3, 2016: International Dental Journal
Akshanth R Polepally, Prajakta S Badri, Apurvasena Parikh, Lino Rodrigues, Barbara A Da Silva-Tillmann, Sven Mensing, Thomas J Podsadecki, Walid M Awni, Sandeep Dutta, Rajeev M Menon
BACKGROUND: The 3 direct-acting antiviral regimen (3D regimen) of ombitasvir, paritaprevir/ritonavir, and dasabuvir, with and without ribavirin, was evaluated in 1 Phase 2 trial and 6 Phase 3 trials in over 2,300 hepatitis C virus genotype 1-infected patients. Patients continued taking their protocol-permitted comedications while receiving the 3D ± ribavirin regimen. The effects of the comedications on exposures of the 3D regimen and ribavirin were examined. METHODS: Population pharmacokinetic model-predicted steady-state area under the curve (AUC24,ss) values were evaluated in the presence/absence of the comedications...
September 1, 2016: Antiviral Therapy
Masataka Fukuoka, Ichiro Kuki, Hisashi Kawawaki, Shin Okazaki, Kiyohiro Kim, Yuka Hattori, Hitomi Tsuji, Megumi Nukui, Takeshi Inoue, Yoko Yoshida, Takehiro Uda, Sadami Kimura, Yukiko Mogami, Yasuhiro Suzuki, Nobuhiko Okamoto, Hirotomo Saitsu, Naomichi Matsumoto
The KCNT1 gene encodes the sodium-dependent potassium channel, with quinidine being a partial antagonist of the KCNT1 channel. Gain-of-function KCNT1 mutations cause early onset epileptic encephalopathies including migrating partial seizures of infancy (MPSI). At 5months of age, our patient presented with epileptic spasms and hypsarrhythmia by electroencephalogram. Psychomotor retardation was observed from early infancy. The patient was diagnosed with West syndrome. Consequently, various anti-epileptic drugs, adrenocorticotropic hormone therapy (twice), and ketogenic diet therapy were tried...
August 28, 2016: Brain & Development
M da Mota Gomes, T Navarro, A Keepanasseril, R Jeffery, R B Haynes
Patient non-adherence to prescribed anti-epileptic drugs (AEDs) remains a challenge to successful treatment of patients with epilepsy. However, the literature on epilepsy does not document a comprehensive review of interventions to improve adherence as a means to improve clinical outcomes. This study systematically reviews existing literature on interventions to enhance AED adherence and clinical outcomes, and the measures of adherence included in these studies. We selected randomized controlled trials (RCTs) of interventions to enhance adherence with AEDs, which also measured clinical outcomes, with at least 80% follow-up of participants for at least 6 months, from a comprehensive Cochrane review of adherence interventions for medications, complete to January 2013, and updated searches for additional AED studies in multiple bibliographic databases to January 2016...
August 29, 2016: Acta Neurologica Scandinavica
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