Use of antiepileptic drugs in childhood epilepsy.

O'Donohoe, N. V.

doi:10.1136/adc.66.10.1173

Cited by 6 publications

(2 citation statements)

References 23 publications

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“…It is thought to act by reducing the excitability of individual neurons and inhibiting the release of glutamate, an excitatory neurotransmitter, via inhibition of voltage-sensitive sodium channels. [10][11][12][13][14][15] While it does not block or reduce the rate of development of kindling, it does decrease the number of kindled responses and the duration of kindled seizures. 16 Further evidence that lamotrigine inhibits glutamate release is exhibited in the rat model, in which kainic acid neurotoxicity, mediated by glutamate release, is inhibited, while quinolinic acid and ibotenic acid neurotoxicity, mediated by N-methyl-D-aspartate (NMDA) receptor excitation, is not.…”

Section: Mechanism Of Actionmentioning

confidence: 99%

Safety and Efficacy of Lamotrigine in Older Adults with Epilepsy and Co-Morbid Depressive Symptoms

Schiller

Krivoy

2009

Clinical Medicine. Therapeutics

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Lamotrigine is an oral well absorbed antiepileptic medication (AED) from the phenyltriazine class approved by the FDA in 1994 for the treatment of epilepsy and in 2003 for the treatment of bipolar disorder. For epilepsy it is used to treat partial seizures, primary and secondary tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome. Lamotrigine is the only AED that treats the depressive as well as the maniac phases of bipolar disorders. It is important to consider lamotrigine adverse reactions and drug-drug interactions such as with other AED's, psychiatric medications, estrogens, and complementary-alternative medicines. Lamotrigine induces skin reactions as part of the hypersensitivity response (HSR), the actual incidence of skin rash is low (1.8%) providing slow escalation regimens are used when introducing this medication. An especially appealing indication for lamotrigine treatment is elderly epilepsy with depression. The main advantage of lamotrigine for the treatment of this indication in the elderly lies in its favorable and predictive adverse event profile and drug-drug interactions in comparison to other AEDs. Lamotrigine can serve in the elderly as both an antiepileptic and an antidepressant drug with a relatively favorable profile.

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Section: Mechanism Of Actionmentioning

confidence: 99%

Safety and Efficacy of Lamotrigine in Older Adults with Epilepsy and Co-Morbid Depressive Symptoms

Schiller

Krivoy

2009

Clinical Medicine. Therapeutics

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“…It has been reported to be more effective in cryptogenic LGS than in symptomatic LGS. [47] Myoclonic, atypical absence and atonic seizures are the seizure types most effectively controlled by valproate in LGS. [48] Gastrointestinal upset and weight gain are common adverse effects but sedation is not a common problem.…”

Section: Valproatementioning

confidence: 99%

Medical Management of Lennox-Gastaut Syndrome

Michoulas

Farrell

2010

CNS Drugs

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Lennox-Gastaut syndrome occurs in 3% of children with epilepsy and is characterized by multiple seizure types, slow spike-and-wave discharges and a poor prognosis for seizure control and cognitive development. Although randomized controlled trials of adjunctive felbamate, lamotrigine, topiramate and rufinamide have demonstrated a > or =50% reduction in seizure frequency, very few children achieve complete seizure control and a Cochrane review of the treatment of Lennox-Gastaut syndrome concluded that the optimum treatment was uncertain and that no drug has been shown to be highly efficacious. Valproate, lamotrigine and topiramate were considered recently by expert panels in the US and Europe to be the first-line drugs. The ketogenic diet may be more effective than antiepileptic drugs and should be considered early in treatment. An improvement in the management of Lennox-Gastaut syndrome requires a better understanding of the pathophysiology of this disorder and the development of animal models in which to test new compounds.

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Therapeutic Drug Monitoring in Pediatrics: A Need for Improvement

Tange

Grey

Senécal

1994

The Journal of Clinical Pharma

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Therapeutic drug monitoring (TDM) is practiced for a number of frequently used drugs in infants and children. It is believed that monitoring drug levels will increase the probability of a therapeutic response and minimize the probability of adverse drug sequelae. Dose adjustments are based on measured drug levels interpreted relative to published therapeutic ranges which may or may not reflect the true relationship with either therapeutic or adverse effects. Potential errors derive from many sources, some amenable to solutions based on current knowledge, others awaiting improved understanding of the causes and consequences of unreliable therapeutic ranges.

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Use of antiepileptic drugs in childhood epilepsy.

Cited by 6 publications

References 23 publications

Safety and Efficacy of Lamotrigine in Older Adults with Epilepsy and Co-Morbid Depressive Symptoms

Safety and Efficacy of Lamotrigine in Older Adults with Epilepsy and Co-Morbid Depressive Symptoms

Medical Management of Lennox-Gastaut Syndrome

Therapeutic Drug Monitoring in Pediatrics: A Need for Improvement

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