Measurement of side effects of anti-epileptic drugs (AEDs) in adults with intellectual disability: A systematic review

Copeland, Lauren; Meek, Andrea Janine; Kerr, Mike; Robling, Michael; Hood, Kerenza; McNamara, Rachel

doi:10.1016/j.seizure.2017.07.013

Cited by 12 publications

(6 citation statements)

References 84 publications

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“…94 A systematic review of tools to measure side effects of AEDs highlighted that, of 108 measures identified, only 8 were appropriate for use in adults with ID, and only 2 measures had been designed for use in people with ID. 95 As a result, side-effect detection is likely to be overly reliant on carer reports and side effects remains under detected. This represents a challenge for doctors, pharmacists and other health professionals in assessing the efficacy and safety of treatment in adults with epilepsy.…”

Section: Antiepileptic Drugsmentioning

confidence: 99%

Medication use and potentially inappropriate prescribing in older adults with intellectual disabilities: a neglected area of research

O'Dwyer

McCallion

McCarron

et al. 2018

Therapeutic Advances in Drug Safety

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It is known that for all adults, prevalence of potentially inappropriate prescribing (PIP) and polypharmacy increases with advancing age and morbidity. This has been associated with adverse drug reactions and poor outcomes. As a result, screening tools have been developed to identify PIP and to improve prescribing and health outcomes. A growing body of evidence supports the fact that there are even greater concerns among older adults with intellectual disability (ID) who are living longer than before but still have premature mortality and poorer health outcomes compared with the general population. They have different patterns of multimorbidity, with higher rates of epilepsy and mental health conditions. Polypharmacy is prevalent and some prescribing practices may be inappropriate. High exposure to anticholinergic and sedative medicines has additional adverse effects on quality of life. There may also be underutilization of clinically needed therapies. There has been substantial controversy internationally relating to extensive use of psychotropic medicines, particularly off-label use for challenging behaviours. Despite the mounting evidence and concerns about the impact of PIP on quality of life, health and safety for people with ID, appropriate methods to measure PIP are lacking, which represents an important gap in the research literature. Differences in morbidity and medicines use patterns in this population mean instruments used to identify inappropriate medicines in the older population are not suitable. In this perspective article we outline the specific health and medicinal needs for people with ID, the prevalence of polypharmacy and presentation of chronic health conditions in older adults with ID. We provide an overview of the psychotropic medicine classes most frequently used in people with ID which carry substantial risk. We highlight studies to date that have attempted to assess PIP and present research priorities to improve prescribing, health outcomes and quality of life for people with ID.

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Section: Antiepileptic Drugsmentioning

confidence: 99%

Medication use and potentially inappropriate prescribing in older adults with intellectual disabilities: a neglected area of research

O'Dwyer

McCallion

McCarron

et al. 2018

Therapeutic Advances in Drug Safety

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show abstract

“…Bu çalışmalardan dört tanesinde LTG entellektüel disabilite üzerine etkisiyle ilgili olup, sadece bir çalışmada LTG'nin yan etki olarak emosyonel değişiklik yaptığı izlenmiştir. [33,34] Literatürden anlaşıldığı gibi antiepileptik ilaçların çocuk ve erişkinlerde sağlıklı ve epileptik bireylerde davranış üzerine etkileri net olarak bilinmemektedir, bu konuda yapılan çalışmalar halen yetersiz görülmektedir.…”

Section: Discussionunclassified

Comparison of the effects of lamotrigine and valproate on the pentylenetetrazole-induced seizures and behaviour of immature rats

Göl¹

2018

Epilepsi

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Objectives: Epileptics, especially children, are more prone to behavioural deficits. Epilepsy related factors, psychosocial problems, treatment side effects may aggravate such deficits. We investigated the effects of lamotrigine and valproate on the behaviour, and pentylenetetrazol (PTZ)-induced seizures on immature rats (21-day-old male). Methods: Three groups 21 day old wistar albino rats were included in this study. In valproate group (n=13), valproate was administered 400 mg/kg/day orally, in lamotrigine group (n=14) lamotrigine was administired 10 mg/kg/day orally, and in control group (n=14) was taken salin orally. All drugs were administered regularly during one month. The behavioral changes of the rats were evaluated by open field test after one month and 100 mg/kg intraperitoneal PTZ were used for induce the seizures. After injection of the PTZ the seizures were evaluated in three groups. Results: Valproate and lamotrigine groups have more emotional activity than the control group. The valproate and the control groups were no different in terms of seizure types and durations. In lamotrigine group, the tonic phase of generalized tonic-clonic seizures did not appear, and the survival during seizures were significantly longer. Conclusion: In this study, demonstrate that valproate and lamotrigine cause anxiety reactions in immature rats and lamotrigine causes longer survival and eliminates the tonic phase of PTZ-induced generalized tonic-clonic seizures.

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“…A recent review by Copeland et al examined measurement tools for adverse medication effect assessment in people with ID. However, this article focuses exclusively on rating scales designed to assess anti-epileptic adverse effects, as opposed to examining adverse medication effect scales in its entirety [ 61 ]. This review adopted a more comprehensive approach, with all medication-related adverse effects scales that are established as applicable, or potentially could be applicable to people with ID with appropriate adaptations, being examined.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Rating scales to measure adverse effects of medications in people with intellectual disability: a scoping review

Kelly

Kilmartin

Lannon

et al. 2022

Eur J Clin Pharmacol

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Purpose Intellectual disability (ID) is a chronic neurodevelopmental condition characterised by limitations in intelligence and adaptive skills with an onset prior to the age of 18 years. People with ID have complex healthcare needs and are more likely than the general population to experience multiple comorbidities and polypharmacy, with subsequent increased risk of adverse medication effects. The aim of this scoping review is to characterise rating scales used to measure adverse effects of medication in people with ID. Methods Four online databases (PsycINFO, Medline, Web of Science and OpenGrey) were searched in April 2020. Studies were assessed for inclusion against pre-specified eligibility criteria. Reference lists of included studies were hand searched. Data extraction was carried out by two independent reviewers and key findings were tabulated for consideration. Studies were assessed for quality using the Mixed Methods Appraisal Tool. Results The search resulted in 512 unique records, of which fifteen met the inclusion criteria. Fourteen scales were identified. All scales assessed adverse effects of psychotropics only. Of the scales, only one, the Matson Evaluation of Drug Side Effects, which focuses on psychotropic medications, was originally developed for use in a population with ID. Conclusion The Matson Evaluation of Drug Side Effects scale appears to be the most reliable and well-researched scale in people with ID. However, a scale which measures adverse effects across multiple medication classes would be valuable for use in this population.

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Measurement of side effects of anti-epileptic drugs (AEDs) in adults with intellectual disability: A systematic review

Cited by 12 publications

References 84 publications

Medication use and potentially inappropriate prescribing in older adults with intellectual disabilities: a neglected area of research

Medication use and potentially inappropriate prescribing in older adults with intellectual disabilities: a neglected area of research

Comparison of the effects of lamotrigine and valproate on the pentylenetetrazole-induced seizures and behaviour of immature rats

Rating scales to measure adverse effects of medications in people with intellectual disability: a scoping review

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