Relationship between adverse effects of antiepileptic drugs, number of coprescribed drugs, and drug load in a large cohort of consecutive patients with drug‐refractory epilepsy

• Published in: Epilepsia (Copenhagen) 2010-05, Vol.51 (5), p.797-804
• Main Authors: Canevini, Maria Paola, De Sarro, Giovambattista, Galimberti, Carlo Andrea, Gatti, Giuliana, Licchetta, Laura, Malerba, Ambra, Muscas, Giancarlo, La Neve, Angela, Striano, Pasquale, Perucca, Emilio
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adverse Drug Reaction Reporting Systems; Adverse effects; Aged; Aged, 80 and over; Anticonvulsants - adverse effects; Anticonvulsants - therapeutic use; Anticonvulsants. Antiepileptics. Antiparkinson agents; Antiepileptic drugs; Biological and medical sciences; Clinical Competence - statistics & numerical data; Cohort Studies; Cross-Sectional Studies; Drug Administration Schedule; Drug load; Drug Prescriptions - statistics & numerical data; Drug Resistance; Drug Therapy, Combination; Drug-Related Side Effects and Adverse Reactions - chemically induced; Drug-Related Side Effects and Adverse Reactions - epidemiology; Epilepsies, Partial - drug therapy; Epilepsy; Epilepsy - drug therapy; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Neuropharmacology; Pharmacology. Drug treatments; Practice Patterns, Physicians' - statistics & numerical data
• ISSN: 0013-9580; 1528-1167
• DOI: 10.1111/j.1528-1167.2010.02520.x

Summary Purpose:  To evaluate the adverse effects (AEs) of antiepileptic drugs (AEDs) in adults with refractory epilepsy and their relationship with number of coprescribed AEDs and AED load. Methods:  Patients with refractory epilepsy were enrolled consecutively at 11 tertiary referral centers. AEs were assessed through unstructured interview and the Adverse Event Profile (AEP) questionnaire. AED loads were calculated as the sum of prescribed daily dose (PDD)/defined daily dose (DDD) ratios for each coprescribed AED. Results:  Of 809 patients enrolled, 709 had localization‐related epilepsy and 627 were on polytherapy. AED loads increased with increasing number of AEDs in the treatment regimen, from 1.2 ± 0.5 for patients on monotherapy to 2.5 ± 1, 3.7 ± 1.1, and 4.7 ± 1.1 for those on two, three, and ≥4 AEDs, respectively. The number of spontaneously reported AEs correlated with the number of AEs identified by the AEP (r = 0.27, p