PMID- 20545754 OWN - NLM STAT- MEDLINE DCOM- 20100712 LR - 20220410 IS - 1528-1167 (Electronic) IS - 0013-9580 (Linking) VI - 51 IP - 5 DP - 2010 May TI - Relationship between adverse effects of antiepileptic drugs, number of coprescribed drugs, and drug load in a large cohort of consecutive patients with drug-refractory epilepsy. PG - 797-804 LID - 10.1111/j.1528-1167.2010.02520.x [doi] AB - PURPOSE: To evaluate the adverse effects (AEs) of antiepileptic drugs (AEDs) in adults with refractory epilepsy and their relationship with number of coprescribed AEDs and AED load. METHODS: Patients with refractory epilepsy were enrolled consecutively at 11 tertiary referral centers. AEs were assessed through unstructured interview and the Adverse Event Profile (AEP) questionnaire. AED loads were calculated as the sum of prescribed daily dose (PDD)/defined daily dose (DDD) ratios for each coprescribed AED. RESULTS: Of 809 patients enrolled, 709 had localization-related epilepsy and 627 were on polytherapy. AED loads increased with increasing number of AEDs in the treatment regimen, from 1.2 +/- 0.5 for patients on monotherapy to 2.5 +/- 1, 3.7 +/- 1.1, and 4.7 +/- 1.1 for those on two, three, and > or =4 AEDs, respectively. The number of spontaneously reported AEs correlated with the number of AEs identified by the AEP (r = 0.27, p < 0.0001). AEP scores did not differ between patients with monotherapy and patients with polytherapy (42.8 +/- 11.7 vs. 42.6 +/- 11.2), and there was no correlation between AEP scores and AED load (r = -0.05, p = 0.16). CONCLUSIONS: AEs did not differ between monotherapy and polytherapy patients, and did not correlate with AED load, possibly as a result of physicians' intervention in individualizing treatment regimens. Taking into account the limitations of a cross-sectional survey, these findings are consistent with the hypothesis that AEs are determined more by individual susceptibility, type of AEDs used, and physicians' skills, than number of coprescribed AEDs and AED load. FAU - Canevini, Maria Paola AU - Canevini MP AD - Division of Neurology 2, Department of Medicine, Surgery, Dentistry, San Paolo Hospital, University of Milan, Milan, Italy. FAU - De Sarro, Giovambattista AU - De Sarro G FAU - Galimberti, Carlo Andrea AU - Galimberti CA FAU - Gatti, Giuliana AU - Gatti G FAU - Licchetta, Laura AU - Licchetta L FAU - Malerba, Ambra AU - Malerba A FAU - Muscas, Giancarlo AU - Muscas G FAU - La Neve, Angela AU - La Neve A FAU - Striano, Pasquale AU - Striano P FAU - Perucca, Emilio AU - Perucca E CN - SOPHIE Study Group LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20100420 PL - United States TA - Epilepsia JT - Epilepsia JID - 2983306R RN - 0 (Anticonvulsants) SB - IM MH - Adolescent MH - Adult MH - Adverse Drug Reaction Reporting Systems MH - Aged MH - Aged, 80 and over MH - Anticonvulsants/*adverse effects/therapeutic use MH - Clinical Competence/statistics & numerical data MH - Cohort Studies MH - Cross-Sectional Studies MH - Drug Administration Schedule MH - Drug Prescriptions/statistics & numerical data MH - Drug Resistance MH - Drug Therapy, Combination MH - Drug-Related Side Effects and Adverse Reactions/*chemically induced/epidemiology MH - Epilepsies, Partial/drug therapy MH - Epilepsy/*drug therapy MH - Female MH - Humans MH - Male MH - Middle Aged MH - Practice Patterns, Physicians'/statistics & numerical data FIR - Perucca, Emilio IR - Perucca E FIR - Baruzzi, Agostino IR - Baruzzi A FIR - De Sarro, Giovambattista IR - De Sarro G FIR - Bonizzoni, Erminio IR - Bonizzoni E FIR - Fattore, Cinzia IR - Fattore C FIR - Franco, Valentina IR - Franco V FIR - Gatti, Giuliana IR - Gatti G FIR - Malerba, Ambra IR - Malerba A FIR - Marzanatti, Mario IR - Marzanatti M FIR - Mazzucchelli, Iolanda IR - Mazzucchelli I FIR - Alexandre, Veriano Jr IR - Alexandre V Jr FIR - Ambrosio, Roberta IR - Ambrosio R FIR - Beccaria, Francesca IR - Beccaria F FIR - Bisulli, Francesca IR - Bisulli F FIR - Cagdas, Sophie IR - Cagdas S FIR - Canevini, Maria Paola IR - Canevini MP FIR - Capovilla, Giuseppe IR - Capovilla G FIR - Ciampa, Clotilde IR - Ciampa C FIR - De Fazio, Salvatore IR - De Fazio S FIR - De Sarro, Giovambattista IR - De Sarro G FIR - Errichiello, Luca IR - Errichiello L FIR - Frassine, Benedetta IR - Frassine B FIR - Galimberti, Carlo Andrea IR - Galimberti CA FIR - Gambardella, Antonio IR - Gambardella A FIR - Gana, Simone IR - Gana S FIR - Giordano, Lucio IR - Giordano L FIR - Guerrini, Renzo IR - Guerrini R FIR - La Briola, Francesca IR - La Briola F FIR - Ladogana, Marianna IR - Ladogana M FIR - Lamberti, Paolo IR - Lamberti P FIR - La Neve, Angela IR - La Neve A FIR - Licchetta, Laura IR - Licchetta L FIR - Muscas, Giancarlo IR - Muscas G FIR - Papantonio, Anna Maria IR - Papantonio AM FIR - Pascarella, Angelo IR - Pascarella A FIR - Pellacani, Simona IR - Pellacani S FIR - Rosati, Eleonora IR - Rosati E FIR - Santulli, Lia IR - Santulli L FIR - Specchio, Luigi Maria IR - Specchio LM FIR - Striano, Pasquale IR - Striano P FIR - Striano, Salvatore IR - Striano S FIR - Tiberti, Alessandra IR - Tiberti A FIR - Tinuper, Paolo IR - Tinuper P FIR - Tozzi, Rossana IR - Tozzi R FIR - Trivisano, Marina IR - Trivisano M EDAT- 2010/06/16 06:00 MHDA- 2010/07/14 06:00 CRDT- 2010/06/16 06:00 PHST- 2010/06/16 06:00 [entrez] PHST- 2010/06/16 06:00 [pubmed] PHST- 2010/07/14 06:00 [medline] AID - EPI2520 [pii] AID - 10.1111/j.1528-1167.2010.02520.x [doi] PST - ppublish SO - Epilepsia. 2010 May;51(5):797-804. doi: 10.1111/j.1528-1167.2010.02520.x. Epub 2010 Apr 20.