▾ Lamotrigine – an add-on antiepileptic

1992 ◽  
Vol 30 (19) ◽  
pp. 75-76
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Antiepileptic Drug ◽  
Partial Seizures ◽  
First Line ◽  
Low Level ◽  
Clonic Seizures ◽  
Clinically Significant ◽  
The Brain

Lamotrigine (Lamictal – Wellcome) is a new antiepileptic drug. It is licensed as ‘add-on’ treatment for patients with partial seizures, either localised to one part of the brain or spreading to tonic-clonic seizures (secondarily generalised), who are not satisfactorily controlled with first-line drugs. The manufacturer claims that it “offers the hope of an improved quality of life” while having “a low level of clinically significant side-effects”. We examine these claims.

Elucidating the Potential Side Effects of Current Anti- Seizure Drugs for Epilepsy

2021 ◽  
Vol 19 ◽  
Author(s):  
Enes Akyüz ◽  
Mohd. Farooq Shaikh ◽  
Betül Köklü ◽  
Cansu Ozenen ◽  
Alina Arulsamy
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adverse Effects ◽  
Side Effect ◽  
First Line ◽  
Epileptic Patients ◽  
Life Threatening ◽  
Visual Problems ◽  
Gaba Transmission

: Over the decades, various interventions have been developed and utilized to treat epilepsy. However, majority of epileptic patients are often first prescribed with anti-epileptic drugs (AED), now known as anti-seizure drugs (ASD), as a first line of defense to suppress their seizures and regain their quality of life. ASDs exert their anti-convulsant effects through various mechanisms of action including regulation of ion channels, blocking of glutamate-mediated stimulating neurotransmitter interaction, and enhancing the inhibitory GABA transmission. About one third of epileptic patients are often resistant to anti-convulsant drugs, while others develop numerous side effects which may lead to treatment discontinuation and further deterioration of quality of life. Common side effects of ASDs include headache, nausea and dizziness. However, more adverse effects such as auditory and visual problems, skin problems, liver dysfunction, pancreatitis and kidney disorders may also be witnessed. Some ASDs may even result in life-threatening conditions as well as serious abnormalities, especially in patients with comorbidities and in pregnant women. Nevertheless, some clinicians had observed a reduction in the development of side effects post individualized ASD treatment. This suggest that a careful and well-informed ASD recommendation to patients may be crucial for an effective and side-effect free control of their seizures. Therefore, this review aimed to elucidate the anticonvulsant effects of ASDs as well as their side effect profile, by discussing their mechanism of action and reported adverse effects based on clinical and preclinical studies, thereby providing clinicians with a greater understanding of the safety of current ASDs.

Cancer-related fatigue in carcinoma urinary bladder patients receiving chemotherapy: A single institutional study from northern India.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 361-361
Author(s):  
Vineet Talwar ◽  
Varun Goel ◽  
Prasanta DASH
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Urinary Bladder ◽  
Clinical Intervention ◽  
Fear Of Pain ◽  
Cancer Related Fatigue ◽  
Northern India ◽  
Clinically Significant ◽  
Loss Of Appetite

361 Background: Fatigue is one of the most disabling phenomenon among patients receiving anti cancer treatment, which has profound effect on their Quality of life (QOL). Although clinicians across the globe acknowledge the importance of regular assessment of fatigue, however it is seldom being assessed and documented in clinical practice in India and very few studies have reported Cancer Related Fatigue among Indian population. Methods: For this study an exploratory design was adopted, using a purposive sampling method. Patients (N=206,) undergoing chemotherapy at Rajiv Gandhi Cancer Hospital and Research Center, Delhi, India; aged 18-83 years were included. The level of fatigue was assessed using 16- item Multidimensional assessment of Fatigue (MAF) scale and a semi structured in depth interview schedule. These interviews were recorded, transcribed and analyzed. Results: Irrespective of age, and education, 81% patients experience clinically significant fatigue. Extreme level of fatigue was reported by 29% patients requiring immediate clinical intervention while 52% patients reported moderate level of clinically significant fatigue. Top four psychosocial issues reported were: apprehension of CT side effects (23.5%), fear of pain (19%), Loss of appetite (17.5%) and anxiety during CT (13.5 %), followed by financial issues (11%). Among all patients, (49.5%) were aware of their diagnosis of which 8% were either fully aware or partially aware about the prognosis (23%). Conclusions: Fatigue remains one of the most important clinical parameters among majority of Carcinoma Urinary Bladder patients receiving chemotherapy, and is neither assessed by clinicians nor reported by majority of the patients. While almost one fourth of the patients report fear of chemotherapy as their pressing psychosocial concern, others report fear of pain, loss of appetite, manifest anxiety symptoms or report financial and logistics issue during CT. Various exercise, educational material and psychotherapeutic interventions should be developed to prepare and support them during their treatment for better preparedness of side effects and their management, reduced symptoms and better quality of life.

scholarly journals Fatigue, quality of life and metabolic changes in men treated with first-line enzalutamide versus abiraterone plus prednisolone for metastatic castration-resistant prostate cancer (HEAT): a randomised trial protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030218
Author(s):  
Klara Kvorning Ternov ◽  
Jens Sønksen ◽  
Mikkel Fode ◽  
Henriette Lindberg ◽  
Caroline Michaela Kistorp ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Adipose Tissue ◽  
Side Effects ◽  
Functional Assessment ◽  
Randomised Trial ◽  
Castration Resistant Prostate Cancer ◽  
First Line ◽  
Castration Resistant

IntroductionEnzalutamide and abiraterone acetate plus prednisolone (AAP) are used in combination with androgen-deprivation therapy to further suppress the androgen stimulation of metastatic castration-resistant prostate cancer (mCRPC). First-line mCRPC treatment with enzalutamide and AAP yields similar overall survival and radiographic progression-free survival in phase III trials. Thus, treatment selection relies on patient choice, cost and side effects. The aim of this randomised trial is to investigate differences in fatigue, health-related quality of life (HRQoL) and metabolic side effects in men with mCRPC treated with first-line enzalutamide versus AAP.Methods and analysisIn this ongoing open-label randomised (1:1) clinical trial, enzalutamide is compared with AAP as first-line treatment for men with mCRPC. The primary endpoint is fatigue assessed with the questionnaire Functional Assessment of Chronic Illness Therapy-Fatigue version 4. Secondary endpoints are changes in body composition (ie, fat mass, visceral adipose tissue, subcutaneous adipose tissue and lean body mass assessed with dual energy X-ray absorptiometry), glucose metabolism assessed with a 2-hour oral glucose tolerance test, serum lipids, blood pressure and HRQoL assessed with the questionnaire Functional Assessment of Cancer Therapy-Prostate (FACT-P). All study endpoints are assessed at baseline and 12-week postintervention. Blood and urine samples are collected at baseline and at time of progression on allocated treatment for future investigation of predictive and prognostic biomarkers in prostate cancer treatment. The planned sample size is 170 participants. All participants are recruited from Herlev and Gentofte Hospital, Denmark. Estimated last patient’s last visit is February 2020.Ethics and disseminationThe study received project approval from the National Committee on Health Research Ethics and Danish Data Protection Agency and Danish Medicines Agency (EudraCT no.: 2017-000027-99). The results of the study will be published in peer-reviewed international journals and will be presented at national and international conferences and symposiums.Trial registration numberClinicaltrialsregister.eu (2017-000099-27).

scholarly journals Symbicort in steroid-dependent asthma: reduction of oral steroids requirements

2005 ◽  
pp. 71-79
Author(s):  
S. N. Avdeev ◽  
Z. S. Etteeva ◽  
N. A. Voznesensky ◽  
N. N. Mesheriakova ◽  
A. G. Chuchalin
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Stability Criteria ◽  
Short Acting ◽  
Asthma Symptoms ◽  
Steroid Dependent ◽  
Severity Scores ◽  
Oral Steroids ◽  
Clinically Significant

Objective: to study the ability of inhaled Symbicort to reduce daily oral steroids (OS) requirements in patients with severe steroid-dependent asthma. Methods: 16 patients with severe steroid-dependent asthma were included into the study (5 males, 11 females, mean age 53 ± 8 years, mean dose of OS 10.9 ± 5.2 mg / day, mean OS treatment duration 9.3 ± 4.1 years, mean FEV1 59.3 ± 15.1%). All patients received Symbicort administered by means of a multidose poder inhaler 4.5 / 160 mkg 2 inhalations twice daily, every 2 weeks patients underwent controlled OS reduction on the basis of predetermined asthma stability criteria. Results: OS was eliminated or reduced in 14 patients (87.5 %), the OS dose was reduced to 3.3 ± 6.8 mg / day (р < 0.001). At the end of 12 weeks of Symbicort therapy FEV1 and FVC increased by 18.6 % and 8.9 %, respectively. Daytime and nighttime asthma symptom severity scores improved in average by 1 point (р < 0.001). The number of inhalations of short-acting β2-agonists reduced from 3.4 ± 1.7 to 1.5 ± 1.3 puffs / day (р < 0.001). Statistically and clinically significant improvements were seen in all 4 domains of quality of life scores (AQLQ) (р < 0.001). The level of NOex reduced significantly form 18.6 ± 11.4 ppb at baseline to 7.9 ± 2.8 ppb after 12 weeks (р = 0.001). The side effects of OS were reduced to the end of study. Conclusion: in patients with severe steroid-dependent asthma therapy with Symbicort allows to eliminate or reduce OS therapy with improved lung function, improved daytime and nighttime asthma symptoms, improved asthma-specific quality of life, reduction of short-acting β2-agonists use and reduction of side effects of OS.

Dysembryoplastic Neuroepithelial Tumors

2018 ◽  
Author(s):  
Clayton L. Haldeman ◽  
John S. Kuo
Keyword(s):  
Quality Of Life ◽  
World Health ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Neuroepithelial Tumors ◽  
Dysembryoplastic Neuroepithelial Tumors ◽  
Intractable Seizures ◽  
Clonic Seizures ◽  
Health Organization

Dysembryoplastic neuroepithelial tumors (DNETs) are World Health Organization grade I tumors and have a low potential for malignant transformation. However, DNETs often affect a patient’s quality of life and can cause medically intractable seizures. The estimated prevalence of DNET is 0.6% to .0.8%; however, they are found in approximately 20% of patients undergoing surgery for epilepsy. Greater than 90% of patients with DNET have onset of epilepsy prior to the age of 20. The most common presentations of DNET are complex partial seizures and simple partial seizures. Generalized tonic–clonic seizures are present in about 50% of patients. Patients are often seizure-free after surgical resection.

scholarly journals New First Line Treatment Options of Clear Cell Renal Cell Cancer Patients with PD-1 or PD-L1 Immune-Checkpoint Inhibitor-Based Combination Therapies

2020 ◽  
Vol 9 (2) ◽  
pp. 565 ◽  
Author(s):  
Marc-Oliver Grimm ◽  
Katharina Leucht ◽  
Viktor Grünwald ◽  
Susan Foller
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Line Treatment ◽  
First Line ◽  
Immune Mediated ◽  
First Line Treatment

In metastatic renal cell carcinoma (mRCC) the PD-1 immune-checkpoint inhibitor (ICI) Nivolumab became a standard second line treatment option in 2015 based on a significant improvement of overall survival compared to Everolimus. Current pivotal phase 3 studies showed that PD-1 ICI-based combinations were more efficacious than the VEGFR-TKI Sunitinib, a previous standard of care, leading to approval of three new regimens as guideline-recommended first-line treatment. Nivolumab plus Ipilimumab is characterized by a survival advantage, a high rate of complete response and durable remissions in intermediate and poor prognosis patients. Despite frequent immune-mediated side effects, fewer symptoms and a better quality of life were observed compared to Sunitinib. Pembrolizumab or Avelumab plus Axitinib were characterized by an improved progression-free-survival and a high response rate with a low rate of intrinsic resistance. In addition, Pembrolizumab plus Axitinib reached a significant survival benefit. The side effect profile is driven by the chronic toxicity of Axitinib, but there is additional risk of immune-mediated side effects of the PD-1/PD-L1 ICIs. The quality of life data published so far do not suggest any improvement regarding patient-reported outcomes compared to the previous standard Sunitinib. The PD-1/PD-L1 ICIs thus form the backbone of the first-line therapy of mRCC.

scholarly journals Levetiracetam and Memory Loss

2019 ◽  
Author(s):  
Elham Alshammari
Keyword(s):  
Quality Of Life ◽  
Memory Loss ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Chronic Disorder ◽  
Different Populations ◽  
Treatment Use ◽  
Electrical Activities ◽  
The Brain

Epilepsy is defined as a chronic disorder that causes a sudden rush of electrical activities in the brain. These seizures may be partial or general. While fractional annexations affect a solitary part of the brain, comprehensive seizures distress the entire brain and its activities. There exist myriad options for seizure treatment. Use of Keppra, the brand name for Levetiracetam, is one of the most adopted forms of treatment. These seizures are generally caused by low blood sugar, alcohol withdrawal as well as head trauma. For one to be prescribed seizure drugs, signs such as simple partial seizures, complex partial seizures as well as general seizures must be present. There are other options for managing seizures such as brain surgery, adopting a Ketogenic diet and anti-epileptic drugs. Levetiracetam is typically prescribed as an add-on to these seizure drugs to boost their effectiveness and as well en- sure improved quality of life. While essential resources and information are recommending the use of Levetiracetam, there are also sources discrediting the drug with evidence of causing memory loss and reduced quality of life. Therefore, this study aims at collecting information from different scholarly articles, journals, and websites about the side effects of using Levetiracetam in different populations. After the data is explored, the study offers a comprehensive conclusion based on the information available. The study, therefore, affirms that the use of Levetiracetam improves the quality of life and it does not affect or interfere with the cognitive functions of the brain. The study seeks to demystify the linking of Levetiracetam to memory loss of its users.

scholarly journals Selective Internal Radiation Combined with Chemotherapy Maintains the Quality of Life in Intrahepatic Cholangiocarcinomas

2021 ◽  
Vol 28 (6) ◽  
pp. 4530-4541
Author(s):  
Camille Goislard de Goislard de Monsabert ◽  
Yann Touchefeu ◽  
Boris Guiu ◽  
Boris Campillo-Gimenez ◽  
Olivier Farges ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Line Treatment ◽  
First Line ◽  
Selective Internal Radiotherapy ◽  
Clinically Significant ◽  
Yttrium 90 ◽  
First Line Treatment ◽  
Intrahepatic Cholangiocarcinomas

Background: In the Yttrium-90 Microspheres in Cholangiocarcinoma (MISPHEC) single-arm phase 2 trial, concomitant chemotherapy and selective internal radiotherapy (SIRT) showed antitumor activity as a first-line treatment of unresectable intrahepatic cholangiocarcinomas (ICCs). In this sub-analysis, we aimed to evaluate one of the secondary endpoints, the health-related quality of life (QoL), evaluated with an EORTC QLQ-C30 instrument at the baseline and during treatment. Methods: The MISPHEC trial included treatment-naïve patients with an unresectable ICC between November 2013 and June 2016. Patients received concomitant first-line chemotherapy with cisplatin and gemcitabine for 8 cycles; SIRT was administered during cycle 1 (for patients with unilobar disease) or cycles 1 and 3 (for patients with bilobar disease) using glass Yttrium-90 microspheres. We evaluated the QoL—measured by the QLQ-C30 questionnaire—at the baseline, every 8 weeks during chemotherapy and follow-up, between 12 and 15 weeks after embolization and every 12 weeks after a liver resection if applicable. Results: A total of 41 patients were included, of which 34 completed questionnaires at the baseline. No clinically significant changes in the global health score or the sub-scales of the QLQ-C30 were observed during follow-up. The physical, social and role function mean score worsened during treatment and fatigue, nausea and pain scores increased although the differences were not clinically significant. In patients undergoing subsequent surgery, the QoL was not impaired. Conclusions: A combination of SIRT and chemotherapy with gemcitabine and cisplatin as the first-line treatment of unresectable ICCs was found to maintain the QoL.

scholarly journals Levetiracetam and Memory Loss

2019 ◽  
Vol 10 (2) ◽  
pp. 1249-1253
Author(s):  
Elham Alshammari
Keyword(s):  
Quality Of Life ◽  
Memory Loss ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Chronic Disorder ◽  
Different Populations ◽  
Treatment Use ◽  
Electrical Activities ◽  
The Brain

Epilepsy is defined as a chronic disorder that causes a sudden rush of electrical activities in the brain. These seizures may be partial or general. While fractional annexations affect a solitary part of the brain, comprehensive seizures distress the entire brain and its activities. There exist myriad options for seizure treatment. Use of Keppra, the brand name for Levetiracetam, is one of the most adopted forms of treatment. These seizures are generally caused by low blood sugar, alcohol withdrawal as well as head trauma. For one to be prescribed seizure drugs, signs such as simple partial seizures, complex partial seizures as well as general seizures must be present. There are other options for managing seizures such as brain surgery, adopting a Ketogenic diet and anti-epileptic drugs. Levetiracetam is typically prescribed as an add-on to these seizure drugs to boost their effectiveness and as well ensure improved quality of life. While essential resources and information are recommending the use of Levetiracetam, there are also sources discrediting the drug with evidence of causing memory loss and reduced quality of life. Therefore, this study aims at collecting information from different scholarly articles, journals, and websites about the side effects of using Levetiracetam in different populations. After the data is explored, the study offers a comprehensive conclusion based on the information available. The study, therefore, affirms that the use of Levetiracetam improves the quality of life and it does not affect or interfere with the cognitive functions of the brain. The study seeks to demystify the linking of Levetiracetam to memory loss of its users.

Proton Pump Inhibitors in 2021: Pros, Cons, and Everything in Between

2021 ◽  
pp. 263451612110217
Author(s):  
Joshua A. Sloan ◽  
Philip O. Katz
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adverse Events ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Drug Class ◽  
Life Threatening

The medical and lay literature has exploded with reports of adverse events associated with proton pump inhibitors over the last 10 to 15 years. The dissemination of these reports to patients and clinicians have created substantial concerns regarding what has been an exceptionally valuable drug class, dramatically improving patient quality of life, and in many cases preventing life threatening side effects of other medication. Patients are more frequently seeking to avoid these medications, and practitioners are reducing or discontinuing them to the patient’s detriment due to a misunderstanding of the data. This review will discuss the data regarding the most commonly publicized adverse events and attempt to put them in perspective.

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