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Paediatric antiepileptic polytherapy: systematic review of efficacy and neurobehavioural effects and a tertiary

D Plevin1, J Jureidini2,3, S Howell4

  • 1Flinders Medical Centre, Bedford Park, SA, Australia.

Acta Paediatrica (Oslo, Norway : 1992)
|April 1, 2018
PubMed

Insights

Antiepileptic polytherapy is common in pediatric epilepsy patients but lacks evidence of efficacy. Clinicians should weigh potential neurobehavioral harms against seizure control benefits.

Area of Science:

  • Pediatric Neurology
  • Clinical Pharmacology

Background:

  • Antiepileptic polytherapy is frequently used in children with epilepsy.
  • Limited evidence exists regarding its efficacy and neurobehavioral safety.

Purpose of the Study:

  • To determine the prevalence of antiepileptic polytherapy in a pediatric tertiary care setting.
  • To systematically review the evidence on the efficacy and neurobehavioral safety of antiepileptic polytherapy in children.

Main Methods:

  • Prevalence assessed via pharmacy dispensing records.
  • Neurobehavioral comorbidities reviewed from patient records.
  • Systematic literature review conducted for safety and efficacy data.

Main Results:

  • Polytherapy was prescribed to 44.7% of pediatric epilepsy patients.
  • Patients with intellectual disability were more likely to receive polytherapy.
  • No trials directly assessed polytherapy efficacy; observational studies linked it to adverse neurobehavioral outcomes.

Conclusions:

  • Antiepileptic polytherapy is prevalent in pediatric epilepsy but lacks supporting efficacy evidence.
  • Randomized controlled trials are challenging in this population.
  • Potential neurobehavioral adverse effects may outweigh seizure control benefits.
Abstract

Keywords:
Antiepileptic drugsEpilepsyPolytherapy

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