PMID- 23673774
OWN - NLM
STAT- MEDLINE
DCOM- 20140113
LR  - 20211021
IS  - 1179-1934 (Electronic)
IS  - 1172-7047 (Linking)
VI  - 27
IP  - 6
DP  - 2013 Jun
TI  - The long-term safety of antiepileptic drugs.
PG  - 435-55
LID - 10.1007/s40263-013-0063-0 [doi]
AB  - Antiepileptic drugs (AEDs) are used by millions of people worldwide for the 
      treatment of epilepsy, as well as in many other neurological and psychiatric 
      conditions. They are frequently associated with adverse effects (AEs), which have 
      an impact on the tolerability and success of treatment. Half the people who 
      develop intolerable AEs discontinue treatment early on after initiation, while 
      the majority of people will continue to be exposed to their effects for long 
      periods of time. The long-term safety of AEDs reflects their potential for 
      chronic, cumulative dose effects; rare, but potentially serious late 
      idiosyncratic effects; late, dose-related effects; and delayed, teratogenic or 
      neurodevelopmental effects. These AEs can affect every body system and are 
      usually insidious. With the exception of delayed effects, most other late or 
      chronic AEs are reversible. To date, there is no clear evidence of a carcinogenic 
      effect of AEDs in humans. While physicians are aware of the long-term AEs of old 
      AEDs (the traditional liver enzyme-inducing AEDs and valproate), information 
      about AEs of new AEDs (such as lamotrigine, levetiracetam, oxcarbazepine, 
      topiramate or zonisamide), particularly of their teratogenic effects, has emerged 
      over the years. Sporadic publications have raised issues about AEs of the newer 
      AEDs eslicarbazepine, retigabine, rufinamide, lacosamide and perampanel but their 
      long-term safety profiles may take years to be fully appreciated. Physicians 
      should not only be aware of the late and chronic AEs of AEDs but should 
      systematically enquire and screen for these according to the individual AED AE 
      profile. Care should be taken for individuals with comorbid conditions that may 
      render them more susceptible to specific AEs. Prevention and appropriate 
      management of long-term AED AEs is expected to improve adherence to treatment, 
      quality of life and control of epilepsy.
FAU - Gaitatzis, Athanasios
AU  - Gaitatzis A
AD  - SEIN-Stichting Epilepsie Instellingen Nederland, Heemstede, The Netherlands.
FAU - Sander, Josemir W
AU  - Sander JW
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - New Zealand
TA  - CNS Drugs
JT  - CNS drugs
JID - 9431220
RN  - 0 (Anticonvulsants)
SB  - IM
MH  - Animals
MH  - Anticonvulsants/administration & dosage/*adverse effects/therapeutic use
MH  - Dose-Response Relationship, Drug
MH  - Drug-Related Side Effects and Adverse Reactions/epidemiology/*etiology
MH  - Epilepsy/drug therapy
MH  - Humans
MH  - Time Factors
EDAT- 2013/05/16 06:00
MHDA- 2014/01/15 06:00
CRDT- 2013/05/16 06:00
PHST- 2013/05/16 06:00 [entrez]
PHST- 2013/05/16 06:00 [pubmed]
PHST- 2014/01/15 06:00 [medline]
AID - 10.1007/s40263-013-0063-0 [doi]
PST - ppublish
SO  - CNS Drugs. 2013 Jun;27(6):435-55. doi: 10.1007/s40263-013-0063-0.