Cardiac adverse effects of antiseizure medications

The epileptic heart: Cardiac comorbidities and complications of epilepsy. Atrial and ventricular structure and function by echocardiography in individuals with epilepsy – From clinical implications to individualized assessment

“…One additional pathway of cardiac involvement in epilepsy is through its treatment. Anti-seizure medication (ASM) is the most important treatment option for epilepsy and has been associated with increased cardiovascular risk, arrhythmias, dyslipidemia, and death [7] , [11] , [34] , [35] , [36] , [37] , [38] . Enzyme-inducing ASM was associated with a 21 % increase in ischemic heart disease or stroke among more than 30 thousand patients with epilepsy with 25 years of follow-up.…”

“…Enzyme-inducing ASMs are associated with increased levels of C-reactive protein, lipoprotein (a), homocysteine, and lipids [34] , [35] . Additionally, the ionic channel blockage properties of some ASM have also been linked to increased cardiovascular risk [7] , [11] , [36] . Sodium channel blockade is associated with an increased risk of sudden cardiac death, total mortality, and non-fatal cardiac arrest, as shown in two landmark trials in individuals with coronary artery disease and heart failure, the CAST (Cardiac Arrhythmia Suppression) and CASH (Cardiac Arrest Study Hamburg) trials [39] , [40] .…”

Risk assessment of arrhythmias related to three antiseizure medications: a systematic review and single-arm meta-analysis

“…However, despite the effectiveness of ASMs in controlling seizures and reducing their frequency and severity ( 8 ), approximately one-third of patients still experience recurrent seizures. It is important to note that ASM is a double-edged sword, as it can cause adverse reactions such as arrhythmia, which is often observed in patients with epilepsy ( 4 , 9 ). Both epilepsy and ASMs were found to be associated with an elevated risk of cardiovascular diseases.…”

“…Antiseizure medications (ASMs) are the first line treatment for seizure disorders (1,2). There is a growing body of evidence that some ASM's are associated with an increased risk for cardiac arrythmias (3)(4)(5)(6). We performed a systematic review to determine the relative risk of arrythmias on three common newer generation ASMs: lacosamide (LCM), levetiracetam (LEV), and perampanel (PER).…”

Intrahippocampal Supramolecular Assemblies Directed Bioorthogonal Liberation of Neurotransmitters to Suppress Seizures in Freely Moving Mice

“…Failure to attain the expected effect of treatment is often caused by the narrow therapeutic window of those drugs, including inadequate ASM dosage, inadequate drug absorption, drug rapid metabolism, and adverse drug reactions. [5][6][7] Therefore, the realization of targeted drug delivery is particularly important for the treatment of epilepsy. [8] Controlled drug delivery systems have emerged as a new frontier in non-genetic neurostimulations.…”