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Adverse drug effects in epileptic patients not correlated with number of prescribed medications
Date:4/20/2010

Researchers have found that polytherapy with multiple anti-epileptic drugs (AEDs) did not result in greater adverse effects than monotherapy for patients with refractory epilepsy. This observational study also found AED load was not a factor in causing adverse effects, but suggests that individual susceptibility, type of AEDs used, and physicians' skills determine which patients suffer adverse effects. Results of this study are available today in Epilepsia, a journal published by Wiley-Blackwell on behalf of the International League Against Epilepsy.

There are more than 20 different AEDs used to treat epilepsy. However, only about one-half of patients become seizure-free with the first prescribed AED; an additional 20% of patients may find complete relief from seizures through a polytherapy AED regimen. The medical community has extensively debated the value of monotherapy versus polytherapy, not only for relative efficacy in reducing frequency of seizures, but also for impact on health-related quality of life (HRQOL). Past studies have indicated that polypharmacy treatment provides only modest advantages in controlling seizures, with the added burden of potentially increasing adverse effects. In contrast, other studies suggest AED toxicity may be better correlated with 'drug load' (the sum of ratios between actual prescribed daily doses and the average therapeutic dose of each drug) than with the number of AEDs administered.

In the current study, 809 epileptic patients were enrolled at 11 tertiary referral centers with 709 participants (344 men and 465 women) having localization-related epilepsy. Mean duration of epilepsy in the study group was over 20 years and the median seizure frequency was 2.5 seizures per month. The most common AEDs prescribed for single AED therapy were carbamazepine, oxcarbazepine, or lamotrigine; one-fourth of participants were treated with monotherapy. In the 627 subjects (77.7%) subjects on polyther
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Contact: Dawn Peters
medicalnews@wiley.com
781-388-8409
Wiley-Blackwell
Source:Eurekalert

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