PMID- 28749393
OWN - NLM
STAT- MEDLINE
DCOM- 20180423
LR  - 20220330
IS  - 0971-5916 (Print)
IS  - 0971-5916 (Linking)
VI  - 145
IP  - 3
DP  - 2017 Mar
TI  - Adverse effects & drug load of antiepileptic drugs in patients with epilepsy: 
      Monotherapy versus polytherapy.
PG  - 317-326
LID - 10.4103/ijmr.IJMR_710_15 [doi]
AB  - BACKGROUND & OBJECTIVES: Although the need for a combination of antiepileptic 
      drugs (AEDs) in the treatment of epilepsy is well justified, but an associated 
      increase in adverse effects (AEs) lends a restriction to polytherapy. The aim of 
      this study was to evaluate AEs and drug load (prescribed daily dose/defined daily 
      doses) of AEDs in patients with epilepsy (PWE). METHODS: Consecutive PWEs 
      attending Epilepsy clinic in a tertiary care hospital in New Delhi, India, were 
      enrolled in the study. Demographic variables, such as age, gender, diagnosis, age 
      at onset of seizures, frequency of seizures, use of all AEDs and adverse event 
      profile (AEP) score were noted. Routine laboratory tests including lipid profile, 
      fasting blood glucose, haematological parameters and liver and kidney function 
      tests were done. RESULTS: A total of 697 consecutive patients were included in 
      this study. Of them, 64.4 per cent were male; mean age was 29.6 +/- 10.6 yr. 
      Generalized seizures and focal seizures were recorded in n=386 (55.4%) and n=311 
      (44.6%), respectively. Monotherapy and polytherapy with two and greater than or 
      equal to three AEDs were prescribed in 264 (37.9%), 243 (34.9%) and 190 (27.2%) 
      patients, respectively. The average AED load, duration of treatment as well as 
      AEP score were found to be significantly higher in combination of greater than or 
      equal to three AEDs as compared to both monotherapy and combination of two AEDs, 
      whereas no significant difference was observed between monotherapy and 
      combination of two AEDs. Patients on monotherapy were in good control of seizures 
      as compared to polytherapy. There was no significant change in biochemical 
      parameters between the groups. INTERPRETATION & CONCLUSIONS: Polytherapy with 
      combination of greater than or equal to three AEDs was associated with higher AEs 
      and lower seizure control as compared to both monotherapy and combination of two 
      AEDs. AEs did not correlate with AED load, seizure type, gender and age of the 
      patients but were associated with both numbers of AEDs as well as seizure 
      frequency in PWE.
FAU - Joshi, Rupa
AU  - Joshi R
AD  - Department of Pharmacology, Child Neurology Division, All India Institute of 
      Medical Sciences, New Delhi, India.
FAU - Tripathi, Manjari
AU  - Tripathi M
AD  - Department of Neurology, Child Neurology Division, All India Institute of Medical 
      Sciences, New Delhi, India.
FAU - Gupta, Pooja
AU  - Gupta P
AD  - Department of Pharmacology, Child Neurology Division, All India Institute of 
      Medical Sciences, New Delhi, India.
FAU - Gulati, Sheffali
AU  - Gulati S
AD  - Department of Paediatrics, Child Neurology Division, All India Institute of 
      Medical Sciences, New Delhi, India.
FAU - Gupta, Yogendra Kumar
AU  - Gupta YK
AD  - Department of Pharmacology, Child Neurology Division, All India Institute of 
      Medical Sciences, New Delhi, India.
LA  - eng
PT  - Journal Article
PL  - India
TA  - Indian J Med Res
JT  - The Indian journal of medical research
JID - 0374701
RN  - 0 (Anticonvulsants)
SB  - IM
CIN - Indian J Med Res. 2017 Mar;145(3):264-266. PMID: 28749388
MH  - Adolescent
MH  - Adult
MH  - Anticonvulsants/adverse effects/*therapeutic use
MH  - Drug Therapy, Combination
MH  - Drug-Related Side Effects and Adverse 
      Reactions/classification/*epidemiology/pathology
MH  - Epilepsy/*drug therapy/epidemiology/pathology
MH  - Female
MH  - Humans
MH  - India
MH  - Male
MH  - Middle Aged
MH  - Seizures/*drug therapy/epidemiology/pathology
PMC - PMC5555059
COIS- Conflicts of Interest: None.
EDAT- 2017/07/28 06:00
MHDA- 2018/04/24 06:00
PMCR- 2017/03/01
CRDT- 2017/07/28 06:00
PHST- 2017/07/28 06:00 [entrez]
PHST- 2017/07/28 06:00 [pubmed]
PHST- 2018/04/24 06:00 [medline]
PHST- 2017/03/01 00:00 [pmc-release]
AID - IndianJMedRes_2017_145_3_317_211677 [pii]
AID - IJMR-145-317 [pii]
AID - 10.4103/ijmr.IJMR_710_15 [doi]
PST - ppublish
SO  - Indian J Med Res. 2017 Mar;145(3):317-326. doi: 10.4103/ijmr.IJMR_710_15.