The evidence for switching dibenzazepines in people with epilepsy

Watkins, Lance; O'Dwyer, Marie Claire; Oak, Katy; Lawthom, Charlotte; Maguire, Melissa; Thomas, Rhys H.; Shankar, Rohit

doi:10.1111/ane.13248

Cited by 10 publications

(3 citation statements)

References 22 publications

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“…The overnight transition between oxcarbazepine and eslicarbazepine acetate (or vice versa) in a 1:1 ratio is generally well tolerated [4][5][6][7]. The overnight transition between carbamazepine and eslicarbazepine acetate (or vice versa) in a ratio of 1:1.3-1.5 is reasonable [4]. In case of need, these drugs can be interchanged instantly considering the above-mentioned ratios.…”

Section: Eslicarbazepine Acetate/oxcarbazepine/ Carbamazepinementioning

confidence: 99%

Recommendations for treatment strategies in people with epilepsy during times of shortage of antiseizure medications

Asadi‐Pooya¹,

Patel²,

Trinka³

et al. 2022

Epileptic Disorders

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In times of severe antiseizure medication (ASM) shortage due to emergency situations (e.g., disasters, conflicts, sudden disruption to international supply chains) management of people with epilepsy (PWE) with available ASMs can be difficult. A group of experts, brought together by the International League Against Epilepsy (ILAE), to formulate recommendations for such circumstances. Every effort was made to base these recommendations on direct published literature or extrapolations from basic information available about ASMs. Actual published literature in this area is however limited and at times, assumptions were made by the experts to generate these recommendations. During times of shortage of ASMs, switching between different ASMs (e.g., oxcarbazepine and carbamazepine) can occasionally be considered as a mitigation procedure. However, for many ASMs, the option of an overnight switch to another drug does not exist. Switching from brand to generic or between generic products has often been shown to be safe, if required. Finally, when supplies of benzodiazepines or equipment to administer medications intravenously are not available, rectal administration of some ASMs may be an emergency alternative route for treating serial seizures and status epilepticus. Decisionmaking with regard to treatment and possible options should be driven by what is best for the patient.

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Section: Eslicarbazepine Acetate/oxcarbazepine/ Carbamazepinementioning

confidence: 99%

Recommendations for treatment strategies in people with epilepsy during times of shortage of antiseizure medications

Asadi‐Pooya¹,

Patel²,

Trinka³

et al. 2022

Epileptic Disorders

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“…Only SANAD I has studied large scale head to head ASM montherapies; the study reported a non-significant advantage of CBZ over OXC [2], ESL was not included in the study. There is however, some emerging, low grade evidence confirming efficacy of the newer dibenzazepines in individuals switched from CBZ to either of the newer agents, as well as some support in switching from OXC to ESL [33,34].…”

Section: Do the New Asms Work As Well As Cbz?mentioning

confidence: 99%

Carbamazepine: Out with the old, in with the new?

Lawthom

2020

Seizure

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“…There are several reports indicating clinical risks associated with a substitution from the original anti-epileptic to a generic (and vice versa) or from one generic to another, such as: adverse events, breakthrough seizures, emergency department visits and hospitalizations [3,[8][9][10][11][12]. In addition to a potential deterioration of treatment effectiveness, a pharmacy switch may challenge a patient's compliance and lead to modifications in his/her anti-epileptic treatment scheme [6,13].…”

Section: Introductionmentioning

confidence: 99%

Attitudes towards the switching of anti-epileptic medications in pharmacies: the patients’ perspective

Bożek¹,

Kurkowska‐Jastrzębska²,

Krzystanek³

et al. 2023

ppn

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Purpose: A survey of epilepsy patients' experiences of and attitudes towards the pharmacy switching of anti-epileptic medications. Methods: A structured questionnaire was administered to a group of epilepsy patients treated at the Institute of Psychiatry and Neurology and the Medical University of Silesia, Poland. Two hundred and eleven patients (mean [± SD] age: 41.0 ± 15.6 years) were recruited; 60.6% were women. 68.2% had been treated for over 10 years. Results: Most individuals (63%) claimed that they had never bought a generic substitute medication. Among the patients who declared that a switch had been proposed to them at a pharmacy (~40%), only 68.7% received any explanation at all from a pharmacist. Some reported positive emotions mostly related to a lower price of the new drug but also to the explanations received. Most respondents who accepted the pharmacy switch (67.4%) did not notice any significant changes in the efficacy or tolerability of treatment, while the remaining subjects reported an increase in seizure frequency (23.2%) and deterioration in treatment tolerance (9%). Conclusions: Around 40% of Polish epilepsy patients have been confronted with a proposal to switch their anti-epileptic medications at a pharmacy. More of them report negative attitudes towards the pharmacist's proposal than do not. It is possible that one of the major reasons for this is the insufficient information provided by pharmacists. It remains to be established whether the reported decrease in seizure control could be accounted for by a low concentration of the anti-epileptic drug in the blood after the switch.

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The evidence for switching dibenzazepines in people with epilepsy

Cited by 10 publications

References 22 publications

Recommendations for treatment strategies in people with epilepsy during times of shortage of antiseizure medications

Recommendations for treatment strategies in people with epilepsy during times of shortage of antiseizure medications

Carbamazepine: Out with the old, in with the new?

Attitudes towards the switching of anti-epileptic medications in pharmacies: the patients’ perspective

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