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Published on: August 15, 2017
Conversions between monotherapies in epilepsy: expert consensus.
Erik K St Louis1, Barry E Gidal, Thomas R Henry
1University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. erik-stlouis@uiowa.edu
Epilepsy & Behavior : E&B
|June 26, 2007
Summary
This study provides expert consensus on converting between antiepileptic drug (AED) monotherapies. Key recommendations include tapering the old drug only after reaching an effective dose of the new one, adjusting for side effects and patient seizure control.
Area of Science:
- Neurology
- Pharmacology
- Clinical Practice Guidelines
Background:
- Converting between antiepileptic drug (AED) monotherapies presents challenges due to limited guidance.
- Establishing expert consensus is crucial for optimizing patient care during medication transitions.
Purpose of the Study:
- To develop expert consensus on the principles and practices for converting between antiepileptic drug (AED) monotherapies.
- To provide practical guidance for clinicians managing AED transitions.
Main Methods:
- An 11-member expert panel utilized the Delphi Technique over three rounds.
- Methods involved issue identification, voting, and consensus development on AED conversion strategies.
Main Results:
- Consensus was reached on tapering the existing AED only after achieving an efficacious dose of the planned AED.
- Recommendations were modified based on adverse effects, seizure control, and driving considerations.
- Titration recommendations for initial and target doses were established for 10 of 12 AEDs.
Conclusions:
- The developed expert guidance facilitates smoother transitions between antiepileptic drug (AED) monotherapies.
- This consensus aids clinicians in managing the transitional polytherapy phase, improving patient outcomes.
- The recommendations supplement existing prescribing information for AED conversions.
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