Marco Mula1, Michael R Trimble, Josemir W Sander. 1. Department of Clinical & Experimental Medicine, Section of Neurology, Amedeo Avogadro University, Novara, Italy. marcomula@yahoo.it
Abstract
PURPOSE: To investigate the hypothesis that some patients with epilepsy are generally prone to develop psychiatric adverse events (PAEs) during antiepileptic drug (AED) therapy irrespective of the mechanism of action of the drugs. METHODS: From a large case registry of patients prescribed topiramate (TPM) and levetiracetam (LEV), data of patients who had a trial with both drugs were analyzed. Demographic and clinical variables of those who developed PAEs with both drugs (group 1) were compared with those who did not (group 2). Subsequently, from the whole case registry, psychopathological features, demographic, and clinical variables of patients developing PAEs with TPM were compared with those of patients developing PAEs with LEV. RESULTS: The case registry included over 800 patients. Among 108 patients having a trial with both drugs, we identified 9 patients in group 1 and 71 in group 2. Previous psychiatric history, family psychiatric history and history of febrile convulsions showed to be significant clinical correlates. Comparing patients who developed PAEs with LEV with those who developed PAEs with TPM, there were no differences in epilepsy related variables. Well-defined DSM-IV disorders were more frequent with TPM than with LEV. Seizure freedom was associated with psychosis. CONCLUSIONS: This study suggests that a subgroup of patients is generally prone to develop PAEs during AED therapy, despite different pharmacological properties of the AEDs. A particular clinical profile and relevant variables have been identified.
PURPOSE: To investigate the hypothesis that some patients with epilepsy are generally prone to develop psychiatric adverse events (PAEs) during antiepileptic drug (AED) therapy irrespective of the mechanism of action of the drugs. METHODS: From a large case registry of patients prescribed topiramate (TPM) and levetiracetam (LEV), data of patients who had a trial with both drugs were analyzed. Demographic and clinical variables of those who developed PAEs with both drugs (group 1) were compared with those who did not (group 2). Subsequently, from the whole case registry, psychopathological features, demographic, and clinical variables of patients developing PAEs with TPM were compared with those of patients developing PAEs with LEV. RESULTS: The case registry included over 800 patients. Among 108 patients having a trial with both drugs, we identified 9 patients in group 1 and 71 in group 2. Previous psychiatric history, family psychiatric history and history of febrile convulsions showed to be significant clinical correlates. Comparing patients who developed PAEs with LEV with those who developed PAEs with TPM, there were no differences in epilepsy related variables. Well-defined DSM-IV disorders were more frequent with TPM than with LEV. Seizure freedom was associated with psychosis. CONCLUSIONS: This study suggests that a subgroup of patients is generally prone to develop PAEs during AED therapy, despite different pharmacological properties of the AEDs. A particular clinical profile and relevant variables have been identified.
Authors: Vincenzo Belcastro; Laura Rosa Pisani; Silvio Bellocchi; Paolo Casiraghi; Gaetano Gorgone; Marco Mula; Francesco Pisani Journal: J Neurol Date: 2017-03-18 Impact factor: 4.849
Authors: Amos D Korczyn; Steven C Schachter; Martin J Brodie; Sarang S Dalal; Jerome Engel; Alla Guekht; Hrvoje Hecimovic; Karim Jerbi; Andres M Kanner; Cecilie Johannessen Landmark; Pavel Mares; Petr Marusic; Stefano Meletti; Marco Mula; Philip N Patsalos; Markus Reuber; Philippe Ryvlin; Klára Štillová; Roberto Tuchman; Ivan Rektor Journal: Epilepsy Behav Date: 2013-06-10 Impact factor: 2.937
Authors: Martin J Brodie; Frank Besag; Alan B Ettinger; Marco Mula; Gabriella Gobbi; Stefano Comai; Albert P Aldenkamp; Bernhard J Steinhoff Journal: Pharmacol Rev Date: 2016-07 Impact factor: 25.468