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Adverse effects of antiepileptic drugs
Piero Perucca1, Frank G Gilliam
1Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
Abstract:
More than 150 years after bromide was introduced as the first antiepileptic drug, adverse effects remain a leading cause of treatment failure and a major determinant of impaired health-related quality of life in people with epilepsy. Adverse effects can develop acutely or many years after starting treatment and can affect any organ or structure. In the past two decades, many efforts have been made to reduce the burden of antiepileptic drug toxicity. Several methods to screen and quantify adverse effects have been developed. Patient profiles associated with increased risk of specific adverse effects have been uncovered through advances in the areas of epidemiology and pharmacogenomics. Several new-generation antiepileptic drugs with improved tolerability profiles and reduced potential for drug interaction have been added to the therapeutic armamentarium. Overall, these advances have expanded the opportunities to tailor treatment with antiepileptic drugs, to enhance effectiveness and minimise the risk of toxic effects.
Insights
Adverse effects of antiepileptic drugs (AEDs) significantly impact epilepsy treatment and quality of life. Recent advances in pharmacogenomics and new drug development offer personalized treatment strategies to improve outcomes.
Area of Science:
- Neurology
- Pharmacology
- Clinical Pharmacy
Background:
- Adverse effects of antiepileptic drugs (AEDs) are a primary reason for treatment failure and reduced quality of life in epilepsy patients.
- These side effects can manifest acutely or chronically, affecting multiple organ systems.
Purpose of the Study:
- To review the advancements in understanding and managing AED-induced adverse effects.
- To highlight strategies for minimizing drug toxicity in epilepsy management.
Main Methods:
- Review of literature on AED adverse effects, epidemiology, and pharmacogenomics.
- Analysis of new-generation AEDs and their tolerability profiles.
- Examination of methods for screening and quantifying adverse effects.
Main Results:
- Significant progress has been made in identifying patient profiles at higher risk for specific adverse effects.
- Development of new AEDs with improved safety profiles and fewer drug interactions.
- Enhanced methods for screening and quantifying AED toxicity.
Conclusions:
- Advances in pharmacogenomics and drug development allow for more tailored epilepsy treatment.
- Personalized AED selection can enhance treatment effectiveness while minimizing toxic effects and improving patient quality of life.
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