Changes in autonomic cardiac control in patients with epilepsy after discontinuation of antiepileptic drugs: a randomized controlled withdrawal study

AbstractAlthough antiepileptic drugs (AEDs) are the most effective treatment for epilepsy, 30–40% of patients with epilepsy would develop drug-refractory epilepsy. An accurate, preliminary prediction of the efficacy of AEDs has great clinical significance for patient treatment and prognosis. Some studies have developed statistical models and machine-learning algorithms (MLAs) to predict the efficacy of AEDs treatment and the progression of disease after treatment withdrawal, in order to provide assistance for making clinical decisions in the aim of precise, personalized treatment. The field of prediction models with statistical models and MLAs is attracting growing interest and is developing rapidly. What’s more, more and more studies focus on the external validation of the existing model. In this review, we will give a brief overview of recent developments in this discipline.

Download Full-text

Effect and Safety of Shihogyejitang for Drug Resistant Childhood Epilepsy

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2016/3410213 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Jinsoo Lee ◽

Kwanghyun Son ◽

Gwiseo Hwang ◽

Moonju Kim

Keyword(s):

Adverse Events ◽

Antiepileptic Drugs ◽

Retention Rate ◽

Seizure Type ◽

Drug Resistant ◽

Exact Test ◽

Alternative Treatment Option ◽

Drug Resistant Epilepsy ◽

Intent To Treat ◽

Patients With Epilepsy

Objective. Herbal medicine has been widely used to treat drug resistant epilepsy. Shihogyejitang (SGT) has been commonly used to treat epilepsy. We investigated the effect and safety of SGT in children with drug resistant epilepsy.Design. We reviewed medical records of 54 patients with epilepsy, who failed to respond to at least two antiepileptic drugs and have been treated with SGT between April 2006 and June 2014 at the Department of Pediatric Neurology, I-Tomato Hospital, Korea. Effect was measured by the response rate, seizure-free rate, and retention rate at six months. We also checked adverse events, change in antiepileptic drugs use, and the variables related to the outcome.Results. Intent-to-treat analysis showed that, after six months, 44.4% showed a >50% seizure reduction, 24.1% including seizure-free, respectively, and 53.7% remained on SGT. Two adverse events were reported, mild skin rash and fever. Focal seizure type presented significantly more positive responses when compared with other seizure types at six months (p=0.0284, Fisher’s exact test).Conclusion. SGT is an effective treatment with excellent tolerability for drug resistant epilepsy patients. Our data provide evidence that SGT may be used as alternative treatment option when antiepileptic drug does not work in epilepsy children.

Download Full-text

The Assessment of Antiepileptic Drugs: Randomized Controlled Trials, Regulation, Clinical Guidelines and Anecdotal Assessment

Atlas of Epilepsies ◽

10.1007/978-1-84882-128-6_215 ◽

2010 ◽

pp. 1431-1434

Author(s):

Simon D. Shorvon

Keyword(s):

Randomized Controlled Trials ◽

Antiepileptic Drugs ◽

Clinical Guidelines ◽

Controlled Trials ◽

Randomized Controlled

Download Full-text

Role of Reflexology and Antiepileptic Drugs in Managing Intractable Epilepsy - a Randomized Controlled Trial

Forschende Komplementärmedizin / Research in Complementary Medicine ◽

10.1159/000350047 ◽

2013 ◽

Vol 20 (2) ◽

pp. 6-6 ◽

Cited By ~ 6

Author(s):

Krishna Dalal ◽

Elanchezhiyan Devarajan ◽

Ravindra Mohan Pandey ◽

Vivekanandan Subbiah ◽

Manjari Tripathi

Keyword(s):

Randomized Controlled Trial ◽

Antiepileptic Drugs ◽

Controlled Trial ◽

Intractable Epilepsy ◽

Randomized Controlled

Download Full-text

Long-term effectiveness and safety of antiepileptic drugs in children and adults

Reviews on Clinical Pharmacology and Drug Therapy ◽

10.17816/rcf192221-228 ◽

2021 ◽

Vol 19 (2) ◽

pp. 221-228

Author(s):

Roza M. Shaimardanova ◽

Rimma G. Gamirova

Keyword(s):

Valproic Acid ◽

Antiepileptic Drugs ◽

Focal Epilepsy ◽

City Hospital ◽

Long Term Follow Up ◽

Short And Long Term ◽

Long Term Observation ◽

Patients With Epilepsy

AIM: To conduct a retrospective comparative analysis of the efficacy and safety of epilepsy therapy with antiepileptic drugs. MATERIALS AND METHODS: The analysis of the treatment of 428 patients with epilepsy at the Childrens City Hospital No. 8 in Kazan, receiving antiepileptic drugs. RESULTS: It was found that valproic acid is more effective in the treatment of idiopathic generalized epilepsies compared to focal epilepsies (p = 0.0006). Valproate and carbamazepine were the most effective in the treatment of focal epilepsy with short- and long-term follow-up. Valproic acid is more effective than topiramate (p = 0.02), oxcarbazepine (p = 0.003), and levetiracetam (p = 0.003) in the treatment of focal epilepsy in short- and long-term follow-up. Carbamazepine is more effective than topiramate (p = 0.01), oxcarbazepine (p = 0.02), and levetiracetam (p = 0.001) in the treatment of focal epilepsy in long-term follow-up. It was revealed that more often they complained about side effects when using carbamazepine (63.2%). Levetiracetam was found to be better tolerated compared to valproate (p = 0.0006) and carbamazepine (p = 0.0006). Topiramate is better tolerated than carbamazepine (p = 0.02) and valproate (p = 0.03). Oxcarbazepine is better tolerated than carbamazepine in women (p = 0.04). CONCLUSIONS: When choosing an antiepileptic drug, it is necessary to be guided by the principle: first the basic, and then the drugs of the next generations, in the future, rely on information about the tolerability of the drug. It is necessary to evaluate the therapeutic effect of antiepileptic drugs with long-term observation, and use the criterion of complete absence of seizures as an indicator of the effectiveness of drugs.

Download Full-text

Withdrawing antiepileptic drugs

Drug and Therapeutics Bulletin ◽

10.1136/dtb.27.8.29 ◽

1989 ◽

Vol 27 (8) ◽

pp. 29-31

Keyword(s):

Antiepileptic Drugs ◽

Drug Withdrawal ◽

Toxic Effects ◽

Patients With Epilepsy

All antiepileptic drugs can cause toxic effects, especially when taken for long periods, and should therefore be discontinued when no longer needed. About 70% of patients with epilepsy eventually enter a prolonged remission and do not then require drugs. We here discuss when and how to attempt drug withdrawal, and what problems may occur.

Download Full-text