Therapeutic experiences with 947 epileptic out-patients in oxcarbazepine treatment

Friis, Mogens Laue; Kristensen, Ole; Boas, J.; Dalby, M. A.; Deth, Sven; Gram, Lennart; Mikkelsen, Marianne; Pedersen, Birthe; Sabers, Anne; Worm-Petersen, J; Andersen, David W.; Jensen, Peter Hjuler

doi:10.1111/j.1600-0404.1993.tb04106.x

Cited by 180 publications

(35 citation statements)

References 7 publications

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“…Among the latest generation of AEDs, oxcarbazepine (OXC) seems to be effective and well tolerated by patients with non-tumoral epilepsy: adverse reactions most frequently reported are hyponatremia (usually asymptomatic and not requiring the suspension of the drug), drowsiness, headache and dizziness, usually of moderate intensity [17,18]. Moreover, an antidepressant effect of OXC was also present, due to stimulation of the dopaminergic system in epileptic patients [19].…”

Section: Introductionmentioning

confidence: 99%

Oxcarbazepine monotherapy in patients with brain tumor-related epilepsy: open-label pilot study for assessing the efficacy, tolerability and impact on quality of life

Maschio¹,

Dinapoli²,

Sperati³

et al. 2011

J Neurooncol

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We conducted a prospective, observational study to verify the efficacy, tolerability and impact on quality of life, mood and global neurocognitive performances of oxcarbazepine monotherapy in patients with brain tumor-related epilepsy (BTRE). Patients were followed for 12 months. We recruited 25 patients (11 females 14 males; mean age 49.7) affected with BTRE (17 de novo patients and 7 in monotherapy with other antiepileptics) and introduced oxcarbazepine monotherapy because of uncontrolled seizures and/or side effects. At first visit, patients underwent neurological examination, Qolie 31P V2, EORTC QLQC30, Zung self-depression rating scale (ZSDRS) and adverse events profile. A seizure diary was given to each patient. Follow-up duration was 1-12 months (mean 7.1 months, 5 patients died and 10 dropped out). Totals of 16 patients underwent both chemotherapy and radiotherapy, 4 chemotherapy only, 1 radiotherapy only, and 4 did not undergo any systemic therapy. Mean dosage of oxcarbazepine was 1,230 mg/day (min 600, max 2,100 mg/day). McNemar's test showed a significant difference in seizure freedom rate (P = 0.002) between baseline and final follow-up in the intent-to-treat population. Six patients (24%) had serious side effects and one patient (4%) mild. Logistic regression revealed that, in our study, chemotherapy and radiotherapy did not affect the efficacy of OXC in seizure outcome (P = 0.658). The test evaluation at final follow-up showed a significant improvement in ZSDRS (P = 0.011) and no change over time. Oxcarbazepine seems to be efficacious in controlling seizures and in improving mood in patients with BTRE, but special caution should be taken when it is administered during radiotherapy.

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Section: Introductionmentioning

confidence: 99%

Oxcarbazepine monotherapy in patients with brain tumor-related epilepsy: open-label pilot study for assessing the efficacy, tolerability and impact on quality of life

Maschio¹,

Dinapoli²,

Sperati³

et al. 2011

J Neurooncol

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“…No special age-related adverse events have been observed. Safety data from more than 6,600 patients with epilepsy, including elderly patients, support the safe use of OXC [34] . However, clinical practice and a vast majority of clinical studies show that patients with dementia respond differently to psychotropic drugs than the healthy elderly, with those with dementia being more sensitive to side effects.…”

Section: Discussionmentioning

confidence: 99%

Effect of Oxcarbazepine in the Treatment of Agitation and Aggression in Severe Dementia

Sommer

Aga²,

Cvancarova

et al. 2009

Dement Geriatr Cogn Disord

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Background/Aims: To evaluate the efficacy of oxcarbazepine (OXC) in the treatment of agitation and aggression in patients with Alzheimer’s disease, vascular dementia or both. Methods: This is an 8-week, multicenter, randomized, double-blind, placebo-controlled trial carried out independently of the pharmaceutical industry. Changes in the agitation and aggression subscore of the Neuropsychiatric Inventory (NPI) were the primary outcomes. The secondary out- comes were the changes in the caregivers’ total burden scores (measured by the NPI) and changes in the Brief Agitation Rating Scale (BARS). Results: In total, 103 institutionalized patients at 35 sites were randomized to the trial. After 8 weeks, no statistically significant differences were found between the 2 groups for all outcomes. A trend was observed in favor of the OXC group in the reduction in the scores on the BARS (p = 0.07). Conclusion: This study found no significant effect of OXC in treatment of agitation and aggression in patients with dementia.

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“…Table 1 summarizes the pharmacokinetic properties of the AEMs, while Table 2 presents a summary of the justifications of TDM for the AEMs. References for reference ranges used in Table 1 are as follows: carbamazepine, clonazepam, phenobarbital, phenytoin, primodone, valproic acid (Hardman et al, 1996), felbamate (Faught et al, 1993;Sachdeo et al, 1992), gabapentin (Lindberger et al, 2003), lacosamide (Kellinghaus, 2009), lamotrigine (Bartoli et al, 1997) (Friis et al, 1993), pregabalin (Patsalos et al, 2008), stiripentol (Farwell et al, 1993), tiagabine (Uthman et al, 1998), topiramate , vigabatrin (Patsalos, 1999), and zonisamide (Glauser & Pippenger, 2000;Mimaki, 1998).…”

Section: Reference Ranges For Aemsmentioning

confidence: 99%

“…Although 10-hydroxycarbazepine distributes into saliva, there are dose-dependent variations in the correlation between 10-hydroxycarbazepine saliva and serum concentrations that limit the utility of saliva as an alternative specimen for TDM of oxcarbazepine (Cardot et al, 1995;Kristensen et al, 1983;Miles et al, 2004). In clinical research studies, a wide range of 10-hydroxycarbazepine serum concentrations (3-35 mg/L) were observed to be clinically effective in seizure treatment (Friis et al, 1993), with toxic side effects being more common at serum/plasma concentrations of 35 mg/L or higher (Striano et al, 2006). TDM for oxcarbazepine is justified when changes are expected that might alter 10-hydroxycarbazepine clearance including pregnancy, concomitant use of liver enzymeinducing drugs, or renal insufficiency.…”

Section: Oxcarbazepinementioning

confidence: 99%

Therapeutic Drug Monitoring of Antiepileptic Medications

Krasowski¹

2011

Novel Treatment of Epilepsy

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Therapeutic experiences with 947 epileptic out-patients in oxcarbazepine treatment

Cited by 180 publications

References 7 publications

Oxcarbazepine monotherapy in patients with brain tumor-related epilepsy: open-label pilot study for assessing the efficacy, tolerability and impact on quality of life

Oxcarbazepine monotherapy in patients with brain tumor-related epilepsy: open-label pilot study for assessing the efficacy, tolerability and impact on quality of life

Effect of Oxcarbazepine in the Treatment of Agitation and Aggression in Severe Dementia

Therapeutic Drug Monitoring of Antiepileptic Medications

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