Cross-sensitivity of psychiatric and behavioral side effects with antiepileptic drug use

• Published in: Seizure (London, England) England), 2018-11, Vol.62, p.38-42
• Main Authors: Chen, Baibing, Choi, Hyunmi, Hirsch, Lawrence J., Legge, Alexander, Buchsbaum, Richard, Detyniecki, Kamil
• Format: Article
• Language: English
• Subjects: Adult; Anticonvulsant; Anticonvulsants - adverse effects; Depression; Drug-Related Side Effects and Adverse Reactions - etiology; Epilepsy - classification; Epilepsy - drug therapy; Female; Humans; Levetiracetam; Male; Mental Disorders - chemically induced; Middle Aged; Psychosis; Psychotic Disorders - etiology; Seizure; Young Adult; Zonisamide
• ISSN: 1059-1311; 1532-2688
• DOI: 10.1016/j.seizure.2018.09.014

•Psychiatric and behavior side effect (IPBSE) cross-sensitivity rates are compared.•Depression and psychosis increase patient risk of experiencing IPBSE to > 2 AEDs.•Risk of experiencing IPBSE to LEV or ZNS increases given IPBSE to any other AED.•The IPBSE cross-sensitivity rate between LEV and ZNS are particularly high. To determine rates of cross-sensitivity of intolerable psychiatric and behavioral side effects (IPBSEs) among commonly used antiepileptic drugs (AEDs) in adult patients with epilepsy. IPBSE was defined as a psychiatric or behavioral side effect attributed to AED use that led to a decrease in dose or cessation of an AED. Cross-sensitivity was calculated and was defined as the likelihood of developing IPBSE to a specific AED given IPBSE to another AED. Our sample consisted of 2312 adult patients that were prescribed 2 or more AEDs. Non-AED confounders and were controlled for in all analyses. Among the 2312 patients, 20.2% of patients who had taken at least 2 AEDs had IPBSE(s) attributed to at least one AED; 3.5% had IPBSE to two or more AEDs. History of treated depression and psychosis were found to be significant predictors (p