Antiepileptic drugs, occurrence of seizures and effect of co‐administration of potential seizure threshold‐lowering psychotropic drugs in adults with intellectual disability who have epilepsy

Author(s):  
Rosemary Monaghan ◽  
Máire O’Dwyer ◽  
Retha Luus ◽  
Niamh Mulryan ◽  
Philip McCallion ◽  
...  
2014 ◽  
Vol 35 (2) ◽  
pp. 364-372 ◽  
Author(s):  
Shang-Wei Hsu ◽  
Po-Huang Chiang ◽  
Yu-Chia Chang ◽  
Jin-Ding Lin ◽  
Ho-Jui Tung ◽  
...  

2020 ◽  
Vol 3 (11) ◽  
pp. e2025570
Author(s):  
Christine Aarenstrup Daugaard ◽  
Lars Pedersen ◽  
Yuelian Sun ◽  
Julie Werenberg Dreier ◽  
Jakob Christensen

CNS Spectrums ◽  
1997 ◽  
Vol 2 (6) ◽  
pp. 68-69
Author(s):  
Cynthia M. Stonnington

AbstractThe risk of psychopathology is greater in persons with epilepsy than it is in the general population. This increased risk is related to a variety of factors including neurobiologic differences associated with epilepsy, medication-related effects, and disease-related psychosocial factors. Choice of appropriate psychoactive therapy must take into consideration effects on seizure threshold and potential interactions with antiepileptic drugs. Identification of psychopathology and effective treatment can reduce unnecessary morbidity in patients already suffering from a chronic disorder.


2017 ◽  
Vol 52 (2) ◽  
pp. 176-189 ◽  
Author(s):  
Rosa M Molina-Ruiz ◽  
Julia Martín-Carballeda ◽  
Inmaculada Asensio-Moreno ◽  
Francisco Montañés-Rada

Background Subjects with intellectual disability are at increased risk of having comorbid psychiatric disorders and worse response to psychotherapeutic and psychopharmacological treatment interventions. On the other hand, available data on best treatment approach in this population are scarce and lack scientific evidence due to methodological limitations. The present study aims to perform a systematic review of the literature to facilitate the use of psychotropic drugs in clinical practice and better establish future research targets in this field. Objectives To review the available psychopharmacological strategies for patients with intellectual disabilities, psychiatric disorders, and behavioural disturbances. Serve as a quick guide for clinicians working in the field of intellectual disability. Methods We conducted a selective evidence-based review of the literature using Pubmed and EMBASE databases and selected most recent and relevant papers for this review. Results There are several available psychotropic drugs for the treatment of patients with intellectual disability and comorbid psychiatric disorders, although scientific evidence is limited. Treatment should be individualized according to risk–benefit balance. Discussion Further studies are needed and new available drugs should be considered to gain knowledge in effectiveness of different therapeutic approaches available in this population.


2018 ◽  
Vol 6 ◽  
pp. 2050313X1877795 ◽  
Author(s):  
Maria Arvio ◽  
Oili Sauna-aho ◽  
Timo Nyrke ◽  
Nina Bjelogrlic-Laakso

We describe here the clinical outcome of four women with epilepsy with eyelid myoclonia (aged 21–53 years). All patients had an uneventful early history, normal physical growth and appearance and no comorbid sensory or motor disability and normal brain magnetic resonance imaging finding. Two women were moderately and one mildly intellectually disabled and one showed a low-average intelligence. The overall well-being of the patients was hampered by psychiatric or various somatic comorbidities and related psychosocial problems. The three women with an intellectual disability had been treated with narrow-spectrum antiepileptic drugs and one also with vigabatrin during childhood and adolescence. The patient with a low-average intelligence had been on broad-spectrum antiepileptic medication (i.e. valproate and ethosuximide) since the epilepsy diagnosis but she has had compliance problems. Based on these cases, the cognitive deficits in patients with epilepsy with eyelid myoclonia may occur more commonly than what has been thought hitherto. We discuss the role of narrow-spectrum antiepileptic drugs as a contributing factor to poor seizure control and an impaired intelligence.


2019 ◽  
Vol 13 (1) ◽  
pp. 41-51 ◽  
Author(s):  
David Branford ◽  
David Gerrard ◽  
Nigget Saleem ◽  
Carl Shaw ◽  
Anne Webster

Purpose The STOMP programme – stopping the over-medication of people with an intellectual disability, autism or both is a three-year programme supported by NHS England. Concern about the overuse of antipsychotic drugs has been a constant theme since the 1970s. However, despite a multitude of guidelines the practice continues. The report into the events at Winterbourne View not only raised concerns about the overuse of antipsychotic drugs but of antidepressants. Part 1 presented the historical background to the use of psychotropic drugs for people with an intellectual disability, autism or both. The purpose of this paper (Part 2) is to present the approach adopted to reduce over-medication (the “Call to Action”) and the progress so far at the half way stage. Design/methodology/approach The “Call to Action” methodology is described in a Manchester University report – mobilising and organising for large-scale change in healthcare “The Right Prescription: A Call to Action on the use of antipsychotic drugs for people with dementia”. Their research suggested that a social mobilising and organising approach to change operates could provide a mechanism for bringing about change where other approaches had failed. Findings The adoption of the “Call to Action” methodology has resulted in widespread acknowledgement across intellectual disability practice that overuse of psychotropic medication and poor review was resulting in over-medication. Many individual local programmes are underway (some are described in this paper) however to what extent the overall use of psychotropic drugs has changed is yet to be evaluated. Originality/value STOMP is part of an English national agenda – transforming care. The government and leading organisations across the health and care system are committed to transforming care for people with intellectual disabilities autism or both who have a mental illness or whose behaviour challenges services. This paper describes a new approach to stopping the over-medication of people with an intellectual disability, autism or both.


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