Cosmetic adverse effects of antiseizure medications; A systematic review

Asadi-Pooya, Ali A.; Rostaminejad, Marzieh; Zeraatpisheh, Zahra; Damabi, Nafiseh Mirzaei

doi:10.1016/j.seizure.2021.05.010

Cited by 7 publications

(6 citation statements)

References 111 publications

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“…Here, not only did the patient experience an improvement of the RLS condition with lamotrigine, upon tapering off because of hirsutism, she experienced a resurgence of the discomfort and asked to be put back on the medication. Of note, hirsutism had previously been reported when under treatment with lamotrigine 59 …”

Section: Discussionmentioning

confidence: 98%

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Anticonvulsant Agents for Treatment of Restless Legs Syndrome

Al-Kassmy,

Alsalmi,

Kang

et al. 2024

The Neurologist

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Introduction: Restless Legs Syndrome (RLS) is a neurological disorder primarily treated with pregabalin and gabapentin, followed by dopamine agonists later in the process due to the risk of augmenting RLS symptoms. In addition, clinical reports have disclosed varying degrees of success employing other agents in patients unresponsive to traditional agents. Here, we present a patient who had success in the reduction of RLS symptoms with lamotrigine, a broad-spectrum anticonvulsant. Previously, lamotrigine had been used in 2 trials with successful treatment of RLS. Case Report: We present a 58-year-old right-handed lady with long-standing history of smoking, hypertension, dyslipidaemia, prediabetes, gastro-esophageal reflux disease, asthma, strabismus, uterine cancer, severe and debilitating course of RLS accompanied by unexplained deterioration. The patient initially demonstrated abnormal sensation in all her limbs, which worsened with radiotherapy treatment, and was eventually diagnosed with RLS based on the diagnostic criteria. Subsequent examinations were unremarkable and revealed no further explanation for the deterioration of the RLS symptoms. While the complexity of the patient’s medical history had exposed her to a variety of medications, she reported that only lamotrigine, in addition to her original regimen of methadone and pramipexole, offered significant symptomatic relief. It must be noted that no adverse side effects, including impulse-control disorder, were reported by the patient. Conclusions: We present a case of a woman whose deteriorating symptoms of RLS were successfully alleviated by the administration of lamotrigine. This is only the third case in the literature to have successfully utilized lamotrigine as a treatment option for RLS.

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Section: Discussionmentioning

confidence: 98%

“…Of note, hirsutism had previously been reported when under treatment with lamotrigine. 59 The reported use of lamotrigine as an adjunct treatment in RLS is minimal in the literature. In comparison to our patient's regimen, 2 case reports have also described lamotrigine use in RLS.…”

Section: Discussionmentioning

confidence: 99%

Anticonvulsant Agents for Treatment of Restless Legs Syndrome

Al-Kassmy,

Alsalmi,

Kang

et al. 2024

The Neurologist

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“…Table 2 Characteristics of Potential adverse effects and comorbidities associated with ASMs (Adapted). 1,2,6,28,[44][45][46][47] Abbreviations: PB, phenobarbital; PHT, phenytoin, TPM, topiramate; BZD, benzodiazepines, such as clobazam, clonazepam; LTG, lamotrigine; LEV, levetiracetam; LCM, lacosamide; CBZ, carbamazepine; OXC, oxcarbazepine; PER, perampanel; GBP, gabapentin; PGB, pregabalin.…”

Section: Enzyme Induction Effectsmentioning

confidence: 99%

Practices in the prescription of antiseizure medications: is it time to change?

Pinto,

Silva,

João

et al. 2024

Arq Neuropsiquiatr

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The treatment of epilepsy has advanced over the past 30 years through the development of new antiseizure medications (ASMs). Unfortunately, not all of them have been approved yet in Brazil, and many are still underused. When comparing new ASMs to older ones, they are generally not more effective in treating epilepsy. However, they offer better tolerability, with fewer interactions and long-term side effects, especially for patients with comorbidities or those requiring polytherapy. Enzyme induction caused by older ASMs is associated with increased cholesterol levels, drug interactions with decreased effects of statins and other cardiovascular medications, anticoagulants, chemotherapy, immunosuppressors, anti-infective agents (including HIV treatment), antidepressants, and contraceptives. Additionally, they can reduce levels of vitamin D and sex hormones, as well as decrease bone density. The increasing concern about these effects during life, especially after prolonged exposure, has led most developed countries to change prescription patterns in favor of new ASMs, particularly levetiracetam and lamotrigine. Both are also considered the safest options for women of childbearing age. Regrettably, the prescription trends in Brazil have remained largely unchanged over time. This can be partially attributed to the slower approval process of ASM and the reluctance of general physicians and neurologists to embrace these new concepts. In this concise review, we highlight the various advantages linked to the new ASM, aiming to promote a shift in the prescription pattern for ASM. The selection of ASM should be customized according to individual characteristics, and practical suggestions for choosing ASMs are provided in this paper.

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“…There are case reports of other drugs including phenobarbital, VPA, carbamazepine, and lamotrigine causing this problem. 73,74 Encouraging oral hygiene can help prevent problematic hyperplasia. In severe cases, surgical reduction of the gum tissue may be necessary.…”

Section: Dermatologicalmentioning

confidence: 99%

Long-Term Effects of Antiseizure Medications

LoPinto-Khoury

2022

Semin Neurol

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Most patients with epilepsy will benefit from seizure control with one of an array of chronic antiseizure medications. Knowledge of the potential long-term effects of these medications is critical to prevent adverse consequences on overall health. Antiseizure medications vary in their capacities to affect the brain and peripheral nerves, hormones, bone mineralization, cardiovascular risk, renal health, hepatic, hematological, and dermatological systems. Understanding of pathophysiology and population risk has evolved, although most of the data available are still on older generation antiseizure medications such as phenytoin, carbamazepine, and valproic acid. The enzyme-inducing properties of some antiseizure medications make their effects on cardiovascular risk and bone health detrimental. Few clear guidelines exist for monitoring long-term effects of medication therapy for epilepsy. When selecting an antiseizure medication, consideration should be given to the individual patient's risks of adverse consequences on other organ systems. During monitoring of patients on chronic therapy, screening tools such as metabolic panels and bone density measurements can help stratify risk and guide management.

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Cosmetic adverse effects of antiseizure medications; A systematic review

Cited by 7 publications

References 111 publications

Anticonvulsant Agents for Treatment of Restless Legs Syndrome

Anticonvulsant Agents for Treatment of Restless Legs Syndrome

Practices in the prescription of antiseizure medications: is it time to change?

Long-Term Effects of Antiseizure Medications

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