PMID- 26709103
OWN - NLM
STAT- MEDLINE
DCOM- 20160920
LR  - 20220317
IS  - 1525-5069 (Electronic)
IS  - 1525-5050 (Linking)
VI  - 54
DP  - 2016 Jan
TI  - Specific adverse effects of antiepileptic drugs--A true-to-life monotherapy 
      study.
PG  - 150-7
LID - S1525-5050(15)00622-8 [pii]
LID - 10.1016/j.yebeh.2015.11.009 [doi]
AB  - BACKGROUND: In patients taking antiepileptic drugs (AEDs) for epilepsy, adverse 
      effects (AEs) often lead to unfavorable quality of life, impaired adherence, and, 
      eventually, discontinuation of pharmacological treatment. In a true-to-life 
      sample of subjects from our academic epilepsy outpatient clinic, we aimed to 
      identify predictors for overall high AE burden and for specific AEs focusing on 
      patients on monotherapy. METHODS: All patients >/=16years of age with epilepsy for 
      >/=12months were routinely asked to complete the Liverpool Adverse Event Profile 
      (LAEP) just before their appointment. Demographic, epilepsy, and treatment 
      variables were derived from our comprehensive outpatient database. RESULTS: Out 
      of 841 patients, 438 (61% female, mean age: 44.7+/-17.1years) on monotherapy were 
      included in this study. Levetiracetam (n=151), lamotrigine (n=167), valproic acid 
      (n=73), or controlled-release carbamazepine (n=47) were the most commonly used 
      antiepileptic drugs (AEDs). Independent predictors for general high AE burden 
      (LAEP score>/=45) were duration of epilepsy, lack of 12-month seizure freedom, and 
      partial epilepsy, but none of the four individual AEDs. The most frequent 
      LAEP-defined specific AEs were sleepiness, difficulty concentrating, tiredness, 
      and memory problems. The three most frequent independent predictors for each of 
      the 19 AEs were lack of 12-month seizure freedom (13/19 AEs), individual AED 
      (7/19 AEs), and partial epilepsy (6/19 AEs). Levetiracetam was independently 
      associated with anger/aggression, nervousness/agitation, upset stomach, 
      depression, and sleep disturbance; lamotrigine with nervousness/agitation, upset 
      stomach, and difficulty concentrating; and valproic acid with upset stomach and 
      shaky hands. CONCLUSION: Individual AEDs independently predicted some specific 
      AEs, but not overall high AE burden. Our findings may help to characterize 
      patients with epilepsy who are at high risk for specific AEs. Dose reduction or 
      change to another AED may reduce LAEP score and potential nonadherence.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Kowski, Alexander B
AU  - Kowski AB
AD  - Epilepsy-Center Berlin-Brandenburg, Department of Neurology, Charite - 
      Universitatsmedizin Berlin, Germany. Electronic address: 
      alexander.kowski@charite.de.
FAU - Weissinger, Florian
AU  - Weissinger F
AD  - Epilepsy-Center Berlin-Brandenburg, Department of Neurology, Charite - 
      Universitatsmedizin Berlin, Germany.
FAU - Gaus, Verena
AU  - Gaus V
AD  - Epilepsy-Center Berlin-Brandenburg, Department of Neurology, Charite - 
      Universitatsmedizin Berlin, Germany.
FAU - Fidzinski, Pawel
AU  - Fidzinski P
AD  - Epilepsy-Center Berlin-Brandenburg, Department of Neurology, Charite - 
      Universitatsmedizin Berlin, Germany.
FAU - Losch, Florian
AU  - Losch F
AD  - Epilepsy-Center Berlin-Brandenburg, Department of Neurology, Charite - 
      Universitatsmedizin Berlin, Germany.
FAU - Holtkamp, Martin
AU  - Holtkamp M
AD  - Epilepsy-Center Berlin-Brandenburg, Department of Neurology, Charite - 
      Universitatsmedizin Berlin, Germany.
LA  - eng
PT  - Journal Article
DEP - 20151218
PL  - United States
TA  - Epilepsy Behav
JT  - Epilepsy & behavior : E&B
JID - 100892858
RN  - 0 (Anticonvulsants)
RN  - 0 (Triazines)
RN  - 33CM23913M (Carbamazepine)
RN  - 44YRR34555 (Levetiracetam)
RN  - 614OI1Z5WI (Valproic Acid)
RN  - U3H27498KS (Lamotrigine)
RN  - ZH516LNZ10 (Piracetam)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anticonvulsants/*adverse effects/therapeutic use
MH  - Anxiety/chemically induced
MH  - Carbamazepine/adverse effects/therapeutic use
MH  - Depression/chemically induced
MH  - Drug-Related Side Effects and Adverse Reactions/diagnosis/epidemiology
MH  - Epilepsy/*diagnosis/*drug therapy/epidemiology
MH  - Fatigue/chemically induced
MH  - Female
MH  - Humans
MH  - Lamotrigine
MH  - Levetiracetam
MH  - Male
MH  - Middle Aged
MH  - Piracetam/adverse effects/analogs & derivatives
MH  - Quality of Life
MH  - Triazines/adverse effects
MH  - Valproic Acid/adverse effects
MH  - Young Adult
OTO - NOTNLM
OT  - Adherence
OT  - Antiepileptic drug
OT  - Epileptic seizure
OT  - Liverpool Adverse Event Profile
OT  - Partial epilepsy
OT  - Seizure freedom
EDAT- 2015/12/29 06:00
MHDA- 2016/09/22 06:00
CRDT- 2015/12/29 06:00
PHST- 2015/09/04 00:00 [received]
PHST- 2015/10/20 00:00 [revised]
PHST- 2015/11/08 00:00 [accepted]
PHST- 2015/12/29 06:00 [entrez]
PHST- 2015/12/29 06:00 [pubmed]
PHST- 2016/09/22 06:00 [medline]
AID - S1525-5050(15)00622-8 [pii]
AID - 10.1016/j.yebeh.2015.11.009 [doi]
PST - ppublish
SO  - Epilepsy Behav. 2016 Jan;54:150-7. doi: 10.1016/j.yebeh.2015.11.009. Epub 2015 
      Dec 18.