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Artykuły w czasopismach na temat „Anticonvulsants”

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Autor: Grafiati

Data publikacji: 4 czerwca 2021

Data aktualizacji: 29 lipca 2024

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1

Perfilyev, V. Yu, A. G. Miroshnichenko, V. A. Zhelev i E. V. Devald. "Alternative anticonvulsants in neonatology". Voprosy praktičeskoj pediatrii 17, nr 4 (2022): 76–83. http://dx.doi.org/10.20953/1817-7646-2022-4-76-83.

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The approaches to pharmacotherapy of neonatal seizures are always empirical and vary across the globe. There is still no consensus on this issue because of the highly variable efficacy of anticonvulsants traditionally used in newborns. Currently, none of these drugs has sufficient evidence to make an unambiguous conclusion on their efficacy and safety. Therefore, the search for new anticonvulsants for newborns is highly relevant. This review aims to summarize existing literature surrounding anticonvulsants that can potentially be used in newborns. It discusses advantages and disadvantages, as well as their utility in neonatal care. It also summarizes the latest information on neonatal seizures and outlines future directions of research to create new therapeutic strategies for neonatal seizures. Key words: anticonvulsant, treatment, neonatal seizures, newborns, anticonvulsant therapy, anticonvulsants, seizures

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2

Burd, Larry, Jack Kerbeshian, Wayne Fisher i Generoso Gascon. "Anticonvulsant Medications: An latrogenic Cause of Tic Disorders". Canadian Journal of Psychiatry 31, nr 5 (czerwiec 1986): 419–23. http://dx.doi.org/10.1177/070674378603100507.

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A review of the relationship between anticonvulsant medications and tics is presented. Data on 5 patients in whom anticonvulsants, either caused tics or exacerbated existing tic disorders is discussed. Discontinuation of the medication resulted in a decrease in the frequency of tickings in all patients. The effects of anticonvulsants on the reticular system are discussed. It is felt that it may be important for clinicians to consider carefully the use of barbiturate anticonvulsants, especially phenobarbital, in children with tics or a family history of tics. Tic disorders caused or exacerbated by exposure to anticonvulsant medications appear to be more common than previously reported, and in some patients the tics may not remit with discontinuation of the medication.

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Cypes, Ilana N., Angel Mier-Hicks, Jordan Scott, Adrienne Groman, Pallawi Torka, Catherine Gawronski i Eugene Przespolewski. "Impact of Anticonvulsant - Methotrexate Interactions on High Dose Methotrexate Clearance and Outcomes in Patients with Primary CNS Lymphoma". Blood 138, Supplement 1 (5.11.2021): 4358. http://dx.doi.org/10.1182/blood-2021-153967.

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Abstract Background: Patients with primary CNS Lymphoma (PCNSL) often present with neurologic complications such as focal defects, neuropsychiatric symptoms, increased intracranial pressure, aphasia, seizures, and ocular symptoms which require initiation of prophylactic or therapeutic anticonvulsants. Most anticonvulsants are notorious for their pharmacodynamic and pharmacokinetic drug interactions. The cornerstone of PCNSL therapy is the utilization of high-dose methotrexate (HD-MTX). The pharmacokinetics of HD-MTX are uniquely sensitive to both disease biology and drug interactions. Due to the importance of both HD-MTX and anticonvulsants in PCNSL patients, these medications are frequently given in concert with one another despite theoretical and proven drug interactions published in the literature. This is a retrospective analysis of patients treated with a modified R-MPV regimen (rituximab, methotrexate, procarbazine, vincristine alternating with intrathecal methotrexate) and the effects of various anticonvulsants on HD-MTX clearance. Methods: Patients ≥18 years of age with a biopsy proven diagnosis of PCNSL at Roswell Park Comprehensive Cancer Center who received R-MPV between January 2002 and December 2019 were included in this retrospective analysis. The electronic health record of each patient was reviewed for specific patient demographics, laboratory results, confounding drug interactions, toxicity, and treatment outcomes. Descriptive statistics were computed for all categorical variables. The time to MTX clearance in hours and the potential impact of concomitant use of various anticonvulsants were assessed using the Wilcoxon Rank Sum test in the case of ordinal responses and the Pearson chi-square test or Fisher's Exact test for categorical variables where appropriate. Results: A total of 67 patients met the inclusion criteria of which 53 patients (79.1%) received anticonvulsants (189 cycles of R-MPV) and 14 did not (69 cycles of R-MPV). Patients who had seizures or frontal brain PCNSL were more likely to receive anticonvulsants (p <0.001). When considering all possible medication interactions with HD-MTX, use of any interacting medication within 48 hours prior to HD-MTX was a predictor of delayed clearance (p = 0.0398). The most common confounding interaction seen in this population were with proton pump inhibitors. Levetiracetam was the most common anticonvulsant used at any point in time during treatment (83.1%). Compared to no anticonvulsant, levetiracetam did not significantly prolong HD-MTX clearance (52.6h v. 72.7h, p = 0.1586). Other anticonvulsants utilized included phenytoin (24.5%), gabapentin (3.8%), valproate (3.8%), carbamazepine (1.9%), lacosamide (1.9%), lamotrigine (1.9%), and phenobarbital (1.9%). Of the patients who received an anticonvulsant, 11 received more than one over the treatment period. Time to clearance of HD-MTX for patients not on an anticonvulsant was 53.8 hours compared to a clearance time of 68.2 hours for those who received an anticonvulsant (p = 0.0571). Patients who received anticonvulsants had a significantly higher complete response rate (79.2% vs 35.7%, p = 0.009), longer progression free survival (25.4 mo vs 3 mo, p = 0.014) and overall survival (56.6 mo vs 4.6 mo, p = 0.002) compared to those who did not (Table 1). There was no difference in grade 3/4 toxicities between anticonvulsants and no anticonvulsants except for thrombocytopenia (p = 0.047) and respiratory side effects (p = 0.035). Conclusion: Anticonvulsants are an essential component to PCNSL therapy in patients on HD-MTX. They are well tolerated, do not alter HD-MTX clearance in a clinically significant manner and may help improve patient outcomes. Figure 1 Figure 1. Disclosures Torka: TG Therapeutics: Membership on an entity's Board of Directors or advisory committees.

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4

Goodwin, Frederick K., i S. Nassir Ghaemi. "The Impact of Mood Stabilizers on Suicide in Bipolar Disorder: A Comparative Analysis". CNS Spectrums 5, S1 (luty 2000): 12–18. http://dx.doi.org/10.1017/s1092852900023245.

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AbstractWhich mood stabilizers are the most effective in reducing suicide rates in patients with bipolar disorder? This paper reviews the literature and compares the data on two types of mood-stabilizing agents, lithium and anticonvulsants. Compared with the large amount of data on lithium, there is surprising little information available on the effects of anticonvulsants on mortality in manic-depressive illness. Each was also assessed in terms of suicide risk factors such as depression and mixed episodes, rapid cycling, substance abuse, anxiety and panic, and central serotonergic function. Only two studies that provide data demonstrating anticonvulsant efficacy in preventing suicide in bipolar disorder are available, and the data are incomplete at best. Further research in this area should include an emphasis on the outcome of mortality in patients treated with any of the anticonvulsants or with lithium-anticonvulsant combinations.

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Ivzhits, M. A., S. K. Zyryanov, G. V. Rodoman, I. B. Bondareva, S. V. Dumova, O. A. Babak, M. S. Chenkurov i G. A. Putsman. "Overview of anticonvulsant therapy in full-term and premature neonates". Russian Journal of Child Neurology 15, nr 2 (28.09.2020): 42–54. http://dx.doi.org/10.17650/2073-8803-2020-15-2-42-54.

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Convulsions in full-term and especially in premature newborns are observable pathologies. Selection of anticonvulsant therapy is very difficult: newborns have particular pharmacokinetics of drugs, insufficient data on doses and therapeutic concentrations of anticonvulsants in the blood (premature infants mainly). This article is an overview, with an emphasis on the features of dosing and pharmacokinetics of anticonvulsants in term and preterm infants.

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Trisovic, Nemanja, Gordana Uscumlic i Slobodan Petrovic. "Hydantoins: Synthesis, properties and anticonvulsant activity". Chemical Industry 63, nr 1 (2009): 17–31. http://dx.doi.org/10.2298/hemind0901017t.

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Hydantoin is a five-membered cyclic ureide that is present in numerous biologically active compounds including antiarrhytmics, anticonvulsants and antitumor agents. This paper describes different ways of synthesis of hydantoin-derivatives, their physical properties and reactivity. Also, the most widely used hydantoin anticonvulsants and the analysis of structureactivity relationships of anticonvulsant drugs in terms of lipophilicity and hydrogen bonding are presented here.

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7

Boarini, David J., David W. Beck i John C. VanGilder. "Postoperative Prophylactic Anticonvulsant Therapy in Cerebral Gliomas". Neurosurgery 16, nr 3 (1.03.1985): 290–92. http://dx.doi.org/10.1227/00006123-198503000-00002.

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Abstract A retrospective study was performed to evaluate the efficacy of prophylactic anticonvulsants in preventing seizures in 68 patients with supratentorial astrocytomas who had been treated with operation and irradiation and who had no previous history of convulsions. Thirty-three patients received prophylactic anticonvulsants and 38 patients did not. The incidence of all types of seizures (generalized convulsions or partial) was lower in patients receiving anticonvulsants. No seizures with an impairment of consciousness occurred in the patients with documented therapeutic anticonvulsant blood levels. The overall incidence of seizures was 39% in untreated patients and 21% in treated patients. The incidence of major seizures including tonic/clonic or partial complex seizures with impairment of consciousness was zero in patients with therapeutic anticonvulsant levels and 18% in untreated patients. Regarding the overall incidence of seizures in both groups, there tend to be fewer seizures in older patients, females, patients with a higher grade of malignancy, and patients who had a more radical resection of the tumor. This study suggests that seizures are a frequent occurrence after operation and irradiation for supratentorial glioma and that anticonvulsants may be effective in reducing the incidence of those seizures.

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8

Perry, J., L. Zinman, A. Chambers, K. Spithoff, N. Lloyd i N. Laperriere. "The Use of Prophylactic Anticonvulsants in Patients with Brain Tumours—A Systematic Review". Current Oncology 13, nr 6 (1.12.2006): 222–29. http://dx.doi.org/10.3747/co.v13i6.107.

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Questions: Should patients with newly diagnosed brain tumours receive prophylactic anticonvulsants to reduce seizure risk? What is the best practice for patients with brain tumours who are taking anticonvulsant medications but who have never had a seizure? Perspectives: Patients with primary or metastatic brain tumours who have never had a seizure still have a 20% risk of experiencing a seizure over the course of their disease. Because considerable practice variation exists in regard to the management of patients with brain tumours who have never had a seizure, and because conflicting evidence has been reported, the Neuro-oncology Disease Site Group (DSG) of Cancer Care Ontario’s Program in Evidence-based Care felt that a systematic review of the evidence was warranted. Outcomes: Outcomes of interest were incidence of seizures and adverse effects of prophylactic anticonvulsant therapy. Methodology: The MEDLINE and Cochrane Library databases were systematically searched for relevant evidence. The review included fully published reports or abstracts of randomized controlled trials (RCTs), systematic reviews, meta-analyses, and practice guidelines. The present systematic review was reviewed and approved by the Neuro-oncology DSG, which comprises medical and radiation oncologists, surgeons, neurologists, a nurse, and a patient representative. Results: Quality of Evidence: The literature search located one evidence-based practice guideline, one systematic review, and five RCTs that addressed prophylactic anticonvulsants for patients with brain tumours. Evidence for the best management of seizure-naïve patients who are already taking anticonvulsants was limited to one retrospective study and exploratory analyses within several RCTs. Benefits and Harms: Pooled results of the five RCTs suggest that the incidence of seizures in patients who receive prophylactic anticonvulsants is not significantly different from that in patients who do not receive anticonvulsants (relative risk: 1.04; 95% confidence interval: 0.70 to 1.54; p = 0.84). This analysis accords with results from a published meta-analysis. Evidence is insufficient to determine whether patients who are currently taking anticonvulsants but who have never had a seizure should taper the anticonvulsants. Patients who received anticonvulsants reported adverse effects, including rash, nausea, and hypotension, but whether these effects are a result of the anticonvulsants or of other treatments could not be determined. Conclusions: Based on the available evidence, the routine use of postoperative anticonvulsants is not recommended in seizure-naïve patients with newly diagnosed primary or secondary brain tumours, especially in light of a significant risk of serious adverse effects and problematic drug interactions. Because data are insufficient to recommend whether anticonvulsants should be tapered in patients who are already taking anticonvulsants but who have never had a seizure, treatment must be individualized.

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Rahajeng, Bangunawati, Zullies Ikawati, Tri Murti Andayani i Iwan Dwiprahasto. "A RETROSPECTIVE STUDY: THE OFF-LABEL USE OF ANTICONVULSANTS AT A PRIVATE HOSPITAL IN INDONESIA". International Journal of Pharmacy and Pharmaceutical Sciences 10, nr 5 (1.05.2018): 119. http://dx.doi.org/10.22159/ijpps.2018v10i5.25388.

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Objective: Anticonvulsant is one class of drugs often used off-label. This study was conducted to investigate the prevalence and the indication of the off-label use of anticonvulsants in a private hospital in Java, Indonesia.Methods: This was an observational study with a retrospective data collection in a private hospital in Java. Data were obtained on the prescription of anticonvulsants. Indications of the use of anticonvulsants were obtained from the medical records of patients who were prescribed anticonvulsants. The off-label use of anticonvulsants was defined a prescribing of medication outside the indication approved by The National Agency of Drug and Food Control Indonesia (NA-DFC). The use off-label of anticonvulsants was calculated by descriptive analysis and presented as a percentage.Results: It showed that in one year there were 5,310 for 1,316 patients: of this 462 patients (35.11%) were for an off-label use. The anticonvulsants used off-label were oxcarbazepine 67.27% (37/55), carbamazepine 46.15% (54/117), pregabalin45.45% (60/132), phenytoin37.62% (225/598), valproate 25.34% (37/109), and gabapentin 18.28% (49/219). The highest off-label use of anticonvulsants was found in neurological and psychiatric disorders 67.32% (n=311), and on 97.19% of them were not supported by strong clinical evidence.Conclusion: The off-label use of anticonvulsants occurred in one-third of patients receiving prescriptions of anticonvulsants, even though for most of them there was a lack of evidence. More attention must be paid to the efficacy and risk of side effects of the drug used.

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Mekhtieva, S. N. "Neuroendocrine disorders in women with epilepsy depending on anticonvulsants intake". Kazan medical journal 94, nr 1 (15.02.2013): 63–67. http://dx.doi.org/10.17816/kmj1772.

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Aim. To assess the influence of epilepsy and anticonvulsants on central control of hormone release and ovarian function in women of reproductive age. Methods. The reproductive and endocrine functions were assessed in 82 female patients with epilepsy, of whom 37 did not receive anticonvulsants (first group), 45 patients were on anticonvulsant treatment (second group). 17 healthy females (control group) were also assessed. Serum levels of estradiol, progesterone, prolactin, luteinizing hormone, follicle-stimulating hormone and dehydroepiandrosterone were estimated during follicular (n=48) and luteal (n=34) stages of menstrual cycle. Results. Estradiol serum level was below normal ranges, and prolactin serum level - above normal limits at follicular stage of menstrual cycle in female patients not treated with anticonvulsants. In luteal phase serum levels of estradiol, progesterone, dehydroepiandrosterone exceeded the reference ranges, and testosterone levels were lower than normal in both patients treated and not treated with anticonvulsants. Comparison of two groups showed that estradiol serum level was lower in untreated patients in both stages of menstrual cycle compared to patients treated with anticonvulsants. There was a marked difference in endocrine function at all levels of reproductive neuroendocrine regulation in untreated female patients compared to female patients treated with anticonvulsants with major transformations in female patients with epilepsy not treated with anticonvulsants. Conclision. Epilepsy and treatment with anticonvulsants can influence the central regulation of hormone release in females.

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DeDonato, Emily A., Henry A. Spiller, Marcel J. Casavant, Thitphalak Chounthirath, Nichole L. Hodges i Gary A. Smith. "Non-health care facility anticonvulsant medication errors in the United States". Human & Experimental Toxicology 37, nr 6 (25.07.2017): 561–70. http://dx.doi.org/10.1177/0960327117721962.

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Introduction: This study provides an epidemiological description of non-health care facility medication errors involving anticonvulsant drugs. Methods: A retrospective analysis of National Poison Data System data was conducted on non-health care facility medication errors involving anticonvulsant drugs reported to US Poison Control Centers from 2000 through 2012. Results: During the study period, 108,446 non-health care facility medication errors involving anticonvulsant pharmaceuticals were reported to US Poison Control Centers, averaging 8342 exposures annually. The annual frequency and rate of errors increased significantly over the study period, by 96.6 and 76.7%, respectively. The rate of exposures resulting in health care facility use increased by 83.3% and the rate of exposures resulting in serious medical outcomes increased by 62.3%. In 2012, newer anticonvulsants, including felbamate, gabapentin, lamotrigine, levetiracetam, other anticonvulsants (excluding barbiturates), other types of gamma aminobutyric acid, oxcarbazepine, topiramate, and zonisamide, accounted for 67.1% of all exposures. Conclusions: The rate of non-health care facility anticonvulsant medication errors reported to Poison Control Centers increased during 2000–2012, resulting in more frequent health care facility use and serious medical outcomes. Newer anticonvulsants, although often considered safer and more easily tolerated, were responsible for much of this trend and should still be administered with caution.

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Banjac, Nebojsa, Nemanja Trisovic, Natasa Valentic, Gordana Uscumlic i Slobodan Petrovic. "Succinimides: Synthesis, properties and anticonvulsant activity". Chemical Industry 65, nr 4 (2011): 439–53. http://dx.doi.org/10.2298/hemind110224030b.

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Succinimide is a cycle imide of succinic acid that is present in numerous biologically active compounds including anticonvulsants, antitremor, anti-Parkinson`s agents. This paper describes different ways of synthesis of succinimide-derivatives their physical properties and reactivity. Also, the most widely used succinimide anticonvulsants and the analysis of structure-activity relationships of anticonvulsant drugs in terms of lipophilicity and hydrogen bonding are presented here.

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Jick, Susan S., i Barbara Z. Terris. "Anticonvulsants and Congenital Malformations". Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy 17, nr 3 (6.05.1997): 561–64. http://dx.doi.org/10.1002/j.1875-9114.1997.tb03065.x.

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Earlier studies indicated that the prevalence of congenital anomalies is greater in infants of epileptic mothers treated with anticonvulsants than in infants of mothers without epilepsy. We carried out a study of women in the General Practice Research Database who delivered liveborn infants between January 1988 and March 1993 and who were exposed to an anticonvulsant drug during the first trimester of pregnancy, and women with epilepsy not treated with anticonvulsants during pregnancy. We matched two nonexposed women without epilepsy to each exposed woman for age at delivery, date of baby's birth, and general practice. Two hundred ninety‐seven women treated for epilepsy had 10 liveborn infants with major anomalies (3.4%) compared with 6 of the 594 nonexposed women (1.0%, RR = 3.3, 95% CI 1.2–9.2). We conclude that the infants of women with epilepsy who are treated with an anticonvulsant during the first trimester of pregnancy have an increased risk of major congenital anomalies.

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Jose, Sona, Amal Roy, N. M. Amala, C. S. Vidhya i Lincy George. "Anticonvulsants in Hepatic Encephalopathy". Journal of Drug Delivery and Therapeutics 14, nr 4 (15.04.2024): 108–10. http://dx.doi.org/10.22270/jddt.v14i4.6506.

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Hepatic encephalopathy (HE) is a complex neurological syndrome that arises as a complication of liver dysfunction. The primary focus in HE management has traditionally been on ammonia detoxification, but recent research has paved light on the potential role of anticonvulsant medications in improving the cognitive impairment and preventing seizures associated with HE. This review mainly aims to provide a comprehensive analysis of the use of anticonvulsants in hepatic encephalopathy, by taking a looking at their mechanisms of action, efficacy, and safety profiles. Keywords: Hepatic encephalopathy, Anticonvulsants, Cognitive impairment

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Mishchenko, Mariia, Sergiy Shtrygol’, Andrii Lozynskyi, Semen Khomyak, Volodymyr Novikov, Olexandr Karpenko, Serhii Holota i Roman Lesyk. "Evaluation of Anticonvulsant Activity of Dual COX-2/5-LOX Inhibitor Darbufelon and Its Novel Analogues". Scientia Pharmaceutica 89, nr 2 (19.05.2021): 22. http://dx.doi.org/10.3390/scipharm89020022.

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Neuroinflammation is an integral part of epilepsy pathogenesis and other convulsive conditions, and non-steroidal anti-inflammatory drugs (NSAIDs) present a potent tool for the contemporary search and design of novel anticonvulsants. In the present paper, evaluation of the anticonvulsant activity of the potential NSAID dual COX-2/5-LOX inhibitor darbufelone methanesulfonate using an scPTZ model in mice in dose 100 mg/kg is reported. Darbufelone possesses anticonvulsant properties in the scPTZ model and presents interest for in-depth studies as a possible anticonvulsant multi-target agent with anti-inflammatory activity. The series of 4-thiazolidinone derivatives have been synthesized following the analogue-based drug design and hybrid-pharmacophore approach using a darbufelone matrix. The synthesized derivatives showed a significant protection level for animals in the scPTZ model and are promising compounds for the design of potential anticonvulsants with satisfactory drug-like parameters.

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Rosenberg, Jennifer M., i Carl Salzman. "Update: New Uses for Lithium and Anticonvulsants". CNS Spectrums 12, nr 11 (listopad 2007): 831–41. http://dx.doi.org/10.1017/s1092852900015571.

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ABSTRACTAnticonvulsants are being used clinically as monotherapy and adjuncts in mental illnesses other than affective disorders. This review focuses on the literature for anticonvulsants and lithium in substance use disorders, anxiety disorders, and schizophrenia. Given the abuse potential and other difficulties with prescribing benzodiazepines for alcohol and benzodiazepine withdrawal, anticonvulsants have been considered as an alternative. Promising therapeutic effects have been demonstrated in many of the anxiety disorders, with the greatest number of trials and positive results in posttraumatic stress disorder. Although anticonvulsant and lithium augmentation for schizophrenia is common in practice and has been studied in double-blind, randomized, controlled trials, the sum of the evidence has been inconclusive.

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Schauf, C. L. "Anticonvulsants modify inactivation but not activation processes of sodium channels in Myxicola axons". Canadian Journal of Physiology and Pharmacology 65, nr 6 (1.06.1987): 1220–25. http://dx.doi.org/10.1139/y87-192.

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The effects of pronase and the anticonvulsant drugs diphenylhydantoin, bepridil, and sodium valproate on fast and slow Na+ inactivation were examined in cut-open Myxicola giant axons with loose patch-clamp electrodes applied to the internal surface. Pronase completely eliminated fast Na+ inactivation without affecting the kinetics of Na+ activation or the maximum Na+ conductance. The time and voltage dependences of slow inactivation following pronase treatment were identical to those measured before enzyme application in the same axons. All three anticonvulsants slowed the time course of recovery from fast Na+ inactivation in untreated axons, and shifted the steady-state fast inactivation curve in the hyperpolarizing direction along the voltage axis. Anticonvulsants enhanced steady-state slow inactivation and retarded recovery from slow inactivation in both untreated and pronase-treated axons. Although some quantitative differences were seen, the order of potency of the anticonvulsants on slow Na+ inactivation was the same as that for recovery from fast inactivation.

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Cohen, N., G. Strauss, R. Lew, D. Silver i L. Recht. "Should prophylactic anticonvulsants be administered to patients with newly-diagnosed cerebral metastases? A retrospective analysis." Journal of Clinical Oncology 6, nr 10 (październik 1988): 1621–24. http://dx.doi.org/10.1200/jco.1988.6.10.1621.

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We analyzed a retrospective series of 195 patients with documented intracerebral metastases (ICM) to assess the frequency of late seizure development and the impact of prophylactic anticonvulsants. Eighteen percent of the patients presented with seizures. Of the remaining patients, 40% received prophylactic anticonvulsants (diphenylhydantoin [DPH] in greater than 90%). Ten percent developed late seizures at an interval from the diagnosis of ICM ranging from 1 to 59 weeks. No patient with a posterior fossa lesion developed seizure; conversely, patients with evidence on initial examination of cerebral hemispheric dysfunction had a higher incidence of late seizure development. The incidence of seizure was virtually identical in patients who received DPH compared with those in whom it was withheld, although two thirds of patients who developed seizure while on DPH had a serum anticonvulsant level that was subtherapeutic. Based on the above findings and until prospective data become available, we recommend that anticonvulsants be withheld in newly-diagnosed patients with ICM until the first seizure.

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Zhou, Kelly Q., Alice McDouall, Paul P. Drury, Christopher A. Lear, Kenta H. T. Cho, Laura Bennet, Alistair J. Gunn i Joanne O. Davidson. "Treating Seizures after Hypoxic-Ischemic Encephalopathy—Current Controversies and Future Directions". International Journal of Molecular Sciences 22, nr 13 (1.07.2021): 7121. http://dx.doi.org/10.3390/ijms22137121.

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Seizures are common in newborn infants with hypoxic-ischemic encephalopathy and are highly associated with adverse neurodevelopmental outcomes. The impact of seizure activity on the developing brain and the most effective way to manage these seizures remain surprisingly poorly understood, particularly in the era of therapeutic hypothermia. Critically, the extent to which seizures exacerbate brain injury or merely reflect the underlying evolution of injury is unclear. Current anticonvulsants, such as phenobarbital and phenytoin have poor efficacy and preclinical studies suggest that most anticonvulsants are associated with adverse effects on the developing brain. Levetiracetam seems to have less potential neurotoxic effects than other anticonvulsants but may not be more effective. Given that therapeutic hypothermia itself has significant anticonvulsant effects, randomized controlled trials of anticonvulsants combined with therapeutic hypothermia, are required to properly determine the safety and efficacy of these drugs. Small clinical studies suggest that prophylactic phenobarbital administration may improve neurodevelopmental outcomes compared to delayed administration; however, larger high-quality studies are required to confirm this. In conclusion, there is a distinct lack of high-quality evidence for whether and to what extent neonatal seizures exacerbate brain damage after hypoxia-ischemia and how best to manage them in the era of therapeutic hypothermia.

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Chow, Ka Yee, Katy Jones i Musa Sami. "Anticonvulsants and antipsychotics for treating anxiety and depressive symptoms in people with alcohol dependence: a systematic review". BJPsych Open 7, S1 (czerwiec 2021): S303. http://dx.doi.org/10.1192/bjo.2021.801.

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AimsAnxiety and depressive symptoms are frequent in people with alcohol use disorders (AUDs) (approximately 55%) and are associated with worse outcomes. Current interventions to treat mood symptoms in alcohol-dependent adults, including psychosocial therapies, anxiolytics and antidepressants have shown limited benefits to date. The efficacy of anticonvulsants and antipsychotics have been studied but never previously systematically reviewed. We aimed to assess the efficacy of anticonvulsants and antipsychotics in treating anxiety and depressive symptoms in alcohol-dependent adults.MethodA literature search of MEDLINE, EMBASE and PsycINFO was performed through October 2020 to identify all English-language articles of double-blinded randomised controlled trials that included adults with AUDs who were treated with an anticonvulsant or antipsychotic for at least four weeks. A combination of search terms was used to describe the AUDs, study medications and the primary outcome. Participants with other psychiatric disorders were excluded. Mean changes in anxiety and depressive scores were evaluated in addition to the adverse events and withdrawal rates. The risk of bias of each study was also assessed.ResultOf 393 citations identified, 23 studies (2823 participants) met the inclusion criteria. Eighteen studies examined ten different anticonvulsants, while five studies examined two antipsychotics. The heterogeneity between the trials' methodology led to conflicting results; however, as the low-quality trials were excluded, the majority agreed that anticonvulsants and antipsychotics were not superior in moderating anxiety and depressive symptoms of alcohol-dependent adults. All antipsychotics were safe and well-tolerated, but adverse events were associated with several anticonvulsants (high dose baclofen, gabapentin, topiramate and valproate).ConclusionCurrent information on anticonvulsants and antipsychotics is insufficient to extrapolate the benefits of treating anxiety and depressive symptoms in alcohol-dependent adults. Further research must be conducted into improving the quality of reporting and understanding the comorbidity's underlying mechanism, and alternative treatment approaches.

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Leander, J. David. "Intraction of the Anticonvulsant Ameltolide with standard Anticonvulsants". Epilepsia 33, nr 4 (lipiec 1992): 705–11. http://dx.doi.org/10.1111/j.1528-1157.1992.tb02351.x.

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Bray, Gary P., Philip M. Harrison, John G. O'Grady, J. Michael Tredger i Roger Williams. "Long-Term Anticonvulsant Therapy Worsens Outcome in Paracetamol-Induced Fulminant Hepatic Failure". Human & Experimental Toxicology 11, nr 4 (lipiec 1992): 265–70. http://dx.doi.org/10.1177/096032719201100405.

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1 Paracetamol hepatotoxicity has been found to be potentiated by anticonvulsant drugs in animal experiments; isolated case reports in humans sugest that long-term anticonvulsant therapy may also adversely influence outcome following overdose. 2 We compared the clinical course, after paracetamol overdose, of 18 patients on long-term anticonvulsant therapy with corresponding features in two published series of paracetamol-induced fulminant hepatic failure from this unit: 297 patients seen between 1973 and 1985 and a further 99 between October 1986 and April 1988. 3 Mortality in those patients who were taking anticonvulsants, but who did not receive N-acetylcysteine, was higher than in either of these series (93.3% vs 64.6% and vs 57.9%, P< 0.025). Although not statistically significant, there were also trends towards more severe coma (grade 3 or 4: 93.3% vs 75.4%, 1986-88), acidosis (pH less than 7.30: 40% vs 22.6%, 1973-85) and coagulopathy (prothrombin time greater than 100 s: 53.3% vs 33.7%, 1973-85). In the small number of patients given N-acetylcysteine, mortality was similar to that in the 1986-88 series (1/3 vs 15/42). 4 We conclude that chronic use of anticonvulsants enhances clinical features of paracetamol toxicity and discuss possible mechanisms by which this could be mediated.

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Falfel, D., H. Ben Ammar, G. Hamdi, E. Khelifa i L. Mnif. "Therapeutic monitoring of mood stabilizers in bipolar disorder". European Psychiatry 64, S1 (kwiecień 2021): S485. http://dx.doi.org/10.1192/j.eurpsy.2021.1296.

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IntroductionEfficacy of lithium is well documented in the literature, making it the gold standard treatment. However, its use declines with the advent of anticonvulsants. This raises the question about monitoring of mood stabilizers in practice.ObjectivesThe aims of this study were to determine the prophylactic lithium response in patients followed for bipolar disorder and compared to those of anticonvulsants and assess the mood stabilizers monitoring procedures in clinical practice.MethodsA retrospective study was conducted, over a period of six months, with patients followed for bipolar disorder stabilized under the same mood stabilizer (lithium or anticonvulsant) for at least one year. The participants were divided into two groups according to the mood stabilizing treatment. The two groups were compared according to socio-demographic, clinical and evolutionary profiles as well as the prophylactic response to treatment.ResultsPatients included were 64 in the study, 28 received lithium and 36 received anticonvulsants. The socio-demographic profile and clinical characteristics were similar in two groups, except for the average total number of mood episodes. Retrospective evaluation of the prophylactic response by ALDA scale showed a significantly higher mean total score in patients receiving lithium (5.9 ± 2.8 versus 2.58 ± 2.4, p = 0.025).). Ten of them were in compliance with the recommendations; while 19.44% received anticonvulsants had all the monitoring parameters within the recommended time frame.ConclusionsThymoregulators significantly modify the disease’s prognosis. Practitioners will attach particular special attention to distinguish the therapeutic efficacy of the side effects which are numerous and sometimes serious.

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Dorson, Peter G. "Psychiatric Uses of Anticonvulsants". Journal of Pharmacy Practice 3, nr 4 (sierpień 1990): 262–75. http://dx.doi.org/10.1177/089719009000300408.

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Anticonvulsants are being used for psychiatric indications with increasing frequency. The potential indications for carbamazepine (CBZ), valproic acid (VPA), clonazepam, and phenytoin are reviewed, with emphasis on double-blind controlled studies where available. Dosage guidelines, adverse effects, and monitoring parameters are reviewed for each of these drugs. The pathophysiological basis for anticonvulsant effectiveness is presented for mood disorders and aggression. CBZ and VPA represent second and third line agents after traditional lithium therapy in bipolar disorder. Clonazepam may be effective in the acute treatment of manic agitation. These alternative agents, when used for appropriate indications, may help the clinician manage the treatment-resistant manic patient. CBZ is also effective for the treatment of aggression and potentially effective for alcohol withdrawal.

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&NA;. "Anticonvulsants". Inpharma Weekly &NA;, nr 1210 (październik 1999): 3. http://dx.doi.org/10.2165/00128413-199912100-00004.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 561 (lipiec 1995): 5. http://dx.doi.org/10.2165/00128415-199505610-00009.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 581 (grudzień 1995): 4. http://dx.doi.org/10.2165/00128415-199505810-00011.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 438 (luty 1993): 5. http://dx.doi.org/10.2165/00128415-199304380-00011.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 450 (maj 1993): 6. http://dx.doi.org/10.2165/00128415-199304500-00023.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 451 (maj 1993): 5. http://dx.doi.org/10.2165/00128415-199304510-00016.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 466 (sierpień 1993): 5. http://dx.doi.org/10.2165/00128415-199304660-00017.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 467 (wrzesień 1993): 5. http://dx.doi.org/10.2165/00128415-199304670-00017.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 468 (wrzesień 1993): 4. http://dx.doi.org/10.2165/00128415-199304680-00016.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 369 (wrzesień 1991): 5. http://dx.doi.org/10.2165/00128415-199103690-00012.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 372 (październik 1991): 3. http://dx.doi.org/10.2165/00128415-199103720-00008.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 374 (październik 1991): 3. http://dx.doi.org/10.2165/00128415-199103740-00007.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 407 (czerwiec 1992): 4. http://dx.doi.org/10.2165/00128415-199204070-00008.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 417 (wrzesień 1992): 5. http://dx.doi.org/10.2165/00128415-199204170-00015.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 420 (wrzesień 1992): 5. http://dx.doi.org/10.2165/00128415-199204200-00013.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 290 (marzec 1990): 4. http://dx.doi.org/10.2165/00128415-199002900-00008.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 294 (marzec 1990): 6. http://dx.doi.org/10.2165/00128415-199002940-00010.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 314 (sierpień 1990): 3. http://dx.doi.org/10.2165/00128415-199003140-00007.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 319 (wrzesień 1990): 4. http://dx.doi.org/10.2165/00128415-199003190-00011.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 335 (styczeń 1991): 3. http://dx.doi.org/10.2165/00128415-199103350-00008.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 339 (luty 1991): 5. http://dx.doi.org/10.2165/00128415-199103390-00011.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 340 (marzec 1991): 4. http://dx.doi.org/10.2165/00128415-199103400-00007.

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&NA;. "Anticonvulsants". Reactions Weekly &NA;, nr 364 (sierpień 1991): 5. http://dx.doi.org/10.2165/00128415-199103640-00009.

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&NA;. "Anticonvulsants". Drugs & Therapy Perspectives 2, nr 3 (sierpień 1993): 7–8. http://dx.doi.org/10.2165/00042310-199302030-00003.

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&NA;. "Anticonvulsants". Journal of Clinical Psychopharmacology 12, nr 5 (październik 1992): 371. http://dx.doi.org/10.1097/00004714-199210000-00022.

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&NA;. "Anticonvulsants". Journal of Clinical Psychopharmacology 12, nr 6 (grudzień 1992): 450. http://dx.doi.org/10.1097/00004714-199212000-00020.

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