Antiepileptic drug therapy for adults: when to initiate and how to choose
Humans; Adult; Treatment Outcome; Risk Factors; Amines; Cyclohexanecarboxylic Acids; gamma-Aminobutyric Acid; Non-U.S. Gov't; Research Support; Recurrence; Epilepsy/drug therapy; Carbamazepine/analogs & derivatives/therapeutic use; Fructose/analogs & derivatives/therapeutic use; Acetic Acids/adverse effects/therapeutic use; Anticonvulsants/adverse effects/therapeutic use; Isoxazoles/therapeutic use; Nipecotic Acids/therapeutic use; Piracetam/analogs & derivatives/therapeutic use; Propylene Glycols/adverse effects/therapeutic use; Triazines/adverse effects/therapeutic use
Although antiepileptic drugs (AEDs) are commonly used to control and prevent seizures, their long-term use carries a considerable risk of morbidity. The decision to start AEDs is made once the risks of further seizures outweigh the risks of treatment. Despite a large body of literature on the subject, this common clinical issue perplexes many practitioners because of its neurologic, psychological, and, at times, legal implications. Adding to the confusion is the recent approval of several new AEDs. This article summarizes the current evidence to support individual clinical decisions regarding initiation of AEDs in adults and considers the use of AEDs as seizure prophylaxis. Recently approved AEDs are discussed to help the practitioner understand when to initiate and how to choose the appropriate AED for the patient with seizures.
2002
Sirven JI
Mayo Clinic Proceedings
2002
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.4065/77.12.1367" target="_blank" rel="noreferrer">10.4065/77.12.1367</a>
Empirical evidence for the use of lithium and anticonvulsants in children with psychiatric disorders
Child; Humans; Anticonvulsants/therapeutic use; Empirical Research; Amines/therapeutic use; Cyclohexanecarboxylic Acids/therapeutic use; gamma-Aminobutyric Acid/therapeutic use; Antimanic Agents/therapeutic use; Carbamazepine/analogs & derivatives/therapeutic use; Drug Therapy/statistics & numerical data; Fructose/analogs & derivatives/therapeutic use; Lithium Carbonate/therapeutic use; Mental Disorders/drug therapy/epidemiology; Triazines/therapeutic use; Valproic Acid/therapeutic use
BACKGROUND: The use of psychotropic medications-in particular, mood stabilizers--in youths with psychiatric illness has grown. There are trends toward polypharmacy and the increased use of newer mood stabilizers in youths with psychiatric illness despite a paucity of studies examining the short- and long-term efficacy and safety of these agents in the pediatric population. METHOD: PubMed was used to identify peer-reviewed publications from the past 30 years (January 1975 to August 2005) studying lithium and anticonvulsants in youths with psychiatric illness. RESULTS: Evidence supporting the use of lithium and valproate in the treatment of juvenile bipolar disorder and reactive aggression has grown. Evidence for the use of other anticonvulsants in youths with psychiatric illness is sparse. Side effects from lithium and anticonvulsants are typically mild to moderate. Data are accumulating in regard to the longer-term safety of lithium and DVPX in the juvenile psychiatric population. Although data in regard to the newer anticonvulsants are limited, they may have more desirable side-effect profiles. CONCLUSION: Double-blind, placebo-controlled trials of lithium and anticonvulsants are greatly needed as clinical use of these agents has risen without sufficient evidence supporting their efficacy in the pediatric population.
2006
Lopez-Larson M; Frazier JA
Harvard Review Of Psychiatry
2006
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1080/10673220601082869" target="_blank" rel="noreferrer">10.1080/10673220601082869</a>