Assessing the unmet treatment need in partial‐onset epilepsy: Looking beyond seizure control
Summary Patients with resistant epilepsy are often coprescribed multiple medications and are more likely to experience drug–drug interactions and adverse events (AEs). A new generation of antiepileptic drugs (AEDs) has been developed with improved safety/tolerability profiles. To evaluate the unmet...
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| Veröffentlicht in: | Epilepsia (Copenhagen) 2010-11, Vol.51 (11), p.2231-2240 |
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| creator | Schmitz, Bettina Montouris, Georgia Schäuble, Barbara Caleo, Sue |
| description | Summary
Patients with resistant epilepsy are often coprescribed multiple medications and are more likely to experience drug–drug interactions and adverse events (AEs). A new generation of antiepileptic drugs (AEDs) has been developed with improved safety/tolerability profiles. To evaluate the unmet treatment needs in epilepsy, a comprehensive search of the English‐language literature was conducted on Medline and other databases using the terms “partial epilepsy” and “focal seizure,” focusing on newer AEDs. Sixty‐nine articles were identified. Most patients experienced AEs, which were generally mild–moderate in severity. Drug–drug interactions existed for 6 of 11 AEDs for which data were available. There is evidence for depressive symptoms being associated with zonisamide, and mood‐stabilizing effects were shown for lamotrigine and pregabalin. Levetiracetam and eslicarbazepine improved cognitive function. Vigabatrin may increase the risk of developing psychosis. Health‐related quality of life (HRQoL) was inversely correlated with seizure frequency. Discontinuation rates were often high, although treatment retention improved with slower dose titration. Adjunctive therapy with newer AEDs has the potential to enhance HRQoL and treatment continuation in patients with partial epilepsy. There remains room for improvement in the management of epilepsy, and better treatments and longer‐term trials are needed to meet the special requirements of refractory patients. |
| doi_str_mv | 10.1111/j.1528-1167.2010.02759.x |
| format | Article |
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Patients with resistant epilepsy are often coprescribed multiple medications and are more likely to experience drug–drug interactions and adverse events (AEs). A new generation of antiepileptic drugs (AEDs) has been developed with improved safety/tolerability profiles. To evaluate the unmet treatment needs in epilepsy, a comprehensive search of the English‐language literature was conducted on Medline and other databases using the terms “partial epilepsy” and “focal seizure,” focusing on newer AEDs. Sixty‐nine articles were identified. Most patients experienced AEs, which were generally mild–moderate in severity. Drug–drug interactions existed for 6 of 11 AEDs for which data were available. There is evidence for depressive symptoms being associated with zonisamide, and mood‐stabilizing effects were shown for lamotrigine and pregabalin. Levetiracetam and eslicarbazepine improved cognitive function. Vigabatrin may increase the risk of developing psychosis. Health‐related quality of life (HRQoL) was inversely correlated with seizure frequency. Discontinuation rates were often high, although treatment retention improved with slower dose titration. Adjunctive therapy with newer AEDs has the potential to enhance HRQoL and treatment continuation in patients with partial epilepsy. There remains room for improvement in the management of epilepsy, and better treatments and longer‐term trials are needed to meet the special requirements of refractory patients.</description><identifier>ISSN: 0013-9580</identifier><identifier>EISSN: 1528-1167</identifier><identifier>DOI: 10.1111/j.1528-1167.2010.02759.x</identifier><identifier>PMID: 20973782</identifier><identifier>CODEN: EPILAK</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Anticonvulsants - adverse effects ; Anticonvulsants - therapeutic use ; Anticonvulsants. Antiepileptics. Antiparkinson agents ; Antiepileptic agents ; Antiepileptic drugs ; Biological and medical sciences ; Clinical trials ; Cognitive ability ; Data processing ; Depression ; Drug Interactions ; Drug Therapy, Combination ; Epilepsies, Partial - drug therapy ; Epilepsies, Partial - psychology ; Epilepsy ; Etiracetam ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Health Services Needs and Demand ; Humans ; lamotrigine ; Medical sciences ; Nervous system (semeiology, syndromes) ; Neurology ; Neuropharmacology ; Pharmacology. Drug treatments ; Psychosis ; Quality of life ; Quality of Life - psychology ; Risk Factors ; Seizures ; Titration ; zonisamide</subject><ispartof>Epilepsia (Copenhagen), 2010-11, Vol.51 (11), p.2231-2240</ispartof><rights>Wiley Periodicals, Inc. © 2010 International League Against Epilepsy</rights><rights>2015 INIST-CNRS</rights><rights>Wiley Periodicals, Inc. © 2010 International League Against Epilepsy.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4969-9e418bb710c7e4d652f6621915ae73368f24016fd843de4ccb353bf7bed9f2173</citedby><cites>FETCH-LOGICAL-c4969-9e418bb710c7e4d652f6621915ae73368f24016fd843de4ccb353bf7bed9f2173</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1528-1167.2010.02759.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1528-1167.2010.02759.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,1434,27929,27930,45579,45580,46414,46838</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23416216$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20973782$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schmitz, Bettina</creatorcontrib><creatorcontrib>Montouris, Georgia</creatorcontrib><creatorcontrib>Schäuble, Barbara</creatorcontrib><creatorcontrib>Caleo, Sue</creatorcontrib><title>Assessing the unmet treatment need in partial‐onset epilepsy: Looking beyond seizure control</title><title>Epilepsia (Copenhagen)</title><addtitle>Epilepsia</addtitle><description>Summary
Patients with resistant epilepsy are often coprescribed multiple medications and are more likely to experience drug–drug interactions and adverse events (AEs). A new generation of antiepileptic drugs (AEDs) has been developed with improved safety/tolerability profiles. To evaluate the unmet treatment needs in epilepsy, a comprehensive search of the English‐language literature was conducted on Medline and other databases using the terms “partial epilepsy” and “focal seizure,” focusing on newer AEDs. Sixty‐nine articles were identified. Most patients experienced AEs, which were generally mild–moderate in severity. Drug–drug interactions existed for 6 of 11 AEDs for which data were available. There is evidence for depressive symptoms being associated with zonisamide, and mood‐stabilizing effects were shown for lamotrigine and pregabalin. Levetiracetam and eslicarbazepine improved cognitive function. Vigabatrin may increase the risk of developing psychosis. Health‐related quality of life (HRQoL) was inversely correlated with seizure frequency. Discontinuation rates were often high, although treatment retention improved with slower dose titration. Adjunctive therapy with newer AEDs has the potential to enhance HRQoL and treatment continuation in patients with partial epilepsy. There remains room for improvement in the management of epilepsy, and better treatments and longer‐term trials are needed to meet the special requirements of refractory patients.</description><subject>Adult</subject><subject>Anticonvulsants - adverse effects</subject><subject>Anticonvulsants - therapeutic use</subject><subject>Anticonvulsants. Antiepileptics. Antiparkinson agents</subject><subject>Antiepileptic agents</subject><subject>Antiepileptic drugs</subject><subject>Biological and medical sciences</subject><subject>Clinical trials</subject><subject>Cognitive ability</subject><subject>Data processing</subject><subject>Depression</subject><subject>Drug Interactions</subject><subject>Drug Therapy, Combination</subject><subject>Epilepsies, Partial - drug therapy</subject><subject>Epilepsies, Partial - psychology</subject><subject>Epilepsy</subject><subject>Etiracetam</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Health Services Needs and Demand</subject><subject>Humans</subject><subject>lamotrigine</subject><subject>Medical sciences</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Neuropharmacology</subject><subject>Pharmacology. Drug treatments</subject><subject>Psychosis</subject><subject>Quality of life</subject><subject>Quality of Life - psychology</subject><subject>Risk Factors</subject><subject>Seizures</subject><subject>Titration</subject><subject>zonisamide</subject><issn>0013-9580</issn><issn>1528-1167</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU2O1DAQhS0EYpqBKyBvEKs0_ot_kFiMRgOM1BIsYIvlOBVIk9jBTsQ0K47AGTkJDt0MS_DGlv29ctV7CGFKtrSsZ_strZmuKJVqy0i5JUzVZntzB21uH-6iDSGUV6bW5Aw9yHlPCFFS8fvojBGjuNJsgz5c5Aw59-Ejnj8BXsIIM54TuHmEMOMA0OI-4MmluXfDz-8_YsiFgKkfYMqH53gX4-dV3cAhhhZn6L8tCbCPYU5xeIjudW7I8Oi0n6P3L6_eXb6udm9eXV9e7CovjDSVAUF10yhKvALRypp1UjJqaO1AcS51xwShsmu14C0I7xte86ZTDbSmY1Txc_T0WHdK8csCebZjnz0MgwsQl2x1LZVkRuh_kkpSIjilpJD6SPoUc07Q2Sn1o0sHS4ldY7B7u7ptV7ftGoP9HYO9KdLHp0-WZoT2VvjH9wI8OQEuezd0yQXf578cF7TMLwv34sh9LX4f_rsBe_X2ej3xX3wppHQ</recordid><startdate>201011</startdate><enddate>201011</enddate><creator>Schmitz, Bettina</creator><creator>Montouris, Georgia</creator><creator>Schäuble, Barbara</creator><creator>Caleo, Sue</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>201011</creationdate><title>Assessing the unmet treatment need in partial‐onset epilepsy: Looking beyond seizure control</title><author>Schmitz, Bettina ; Montouris, Georgia ; Schäuble, Barbara ; Caleo, Sue</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4969-9e418bb710c7e4d652f6621915ae73368f24016fd843de4ccb353bf7bed9f2173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Anticonvulsants - adverse effects</topic><topic>Anticonvulsants - therapeutic use</topic><topic>Anticonvulsants. Antiepileptics. Antiparkinson agents</topic><topic>Antiepileptic agents</topic><topic>Antiepileptic drugs</topic><topic>Biological and medical sciences</topic><topic>Clinical trials</topic><topic>Cognitive ability</topic><topic>Data processing</topic><topic>Depression</topic><topic>Drug Interactions</topic><topic>Drug Therapy, Combination</topic><topic>Epilepsies, Partial - drug therapy</topic><topic>Epilepsies, Partial - psychology</topic><topic>Epilepsy</topic><topic>Etiracetam</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Health Services Needs and Demand</topic><topic>Humans</topic><topic>lamotrigine</topic><topic>Medical sciences</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Neuropharmacology</topic><topic>Pharmacology. Drug treatments</topic><topic>Psychosis</topic><topic>Quality of life</topic><topic>Quality of Life - psychology</topic><topic>Risk Factors</topic><topic>Seizures</topic><topic>Titration</topic><topic>zonisamide</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schmitz, Bettina</creatorcontrib><creatorcontrib>Montouris, Georgia</creatorcontrib><creatorcontrib>Schäuble, Barbara</creatorcontrib><creatorcontrib>Caleo, Sue</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>Epilepsia (Copenhagen)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schmitz, Bettina</au><au>Montouris, Georgia</au><au>Schäuble, Barbara</au><au>Caleo, Sue</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessing the unmet treatment need in partial‐onset epilepsy: Looking beyond seizure control</atitle><jtitle>Epilepsia (Copenhagen)</jtitle><addtitle>Epilepsia</addtitle><date>2010-11</date><risdate>2010</risdate><volume>51</volume><issue>11</issue><spage>2231</spage><epage>2240</epage><pages>2231-2240</pages><issn>0013-9580</issn><eissn>1528-1167</eissn><coden>EPILAK</coden><abstract>Summary
Patients with resistant epilepsy are often coprescribed multiple medications and are more likely to experience drug–drug interactions and adverse events (AEs). A new generation of antiepileptic drugs (AEDs) has been developed with improved safety/tolerability profiles. To evaluate the unmet treatment needs in epilepsy, a comprehensive search of the English‐language literature was conducted on Medline and other databases using the terms “partial epilepsy” and “focal seizure,” focusing on newer AEDs. Sixty‐nine articles were identified. Most patients experienced AEs, which were generally mild–moderate in severity. Drug–drug interactions existed for 6 of 11 AEDs for which data were available. There is evidence for depressive symptoms being associated with zonisamide, and mood‐stabilizing effects were shown for lamotrigine and pregabalin. Levetiracetam and eslicarbazepine improved cognitive function. Vigabatrin may increase the risk of developing psychosis. Health‐related quality of life (HRQoL) was inversely correlated with seizure frequency. Discontinuation rates were often high, although treatment retention improved with slower dose titration. Adjunctive therapy with newer AEDs has the potential to enhance HRQoL and treatment continuation in patients with partial epilepsy. There remains room for improvement in the management of epilepsy, and better treatments and longer‐term trials are needed to meet the special requirements of refractory patients.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>20973782</pmid><doi>10.1111/j.1528-1167.2010.02759.x</doi><tpages>10</tpages></addata></record> |
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| ispartof | Epilepsia (Copenhagen), 2010-11, Vol.51 (11), p.2231-2240 |
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| subjects | Adult Anticonvulsants - adverse effects Anticonvulsants - therapeutic use Anticonvulsants. Antiepileptics. Antiparkinson agents Antiepileptic agents Antiepileptic drugs Biological and medical sciences Clinical trials Cognitive ability Data processing Depression Drug Interactions Drug Therapy, Combination Epilepsies, Partial - drug therapy Epilepsies, Partial - psychology Epilepsy Etiracetam Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Health Services Needs and Demand Humans lamotrigine Medical sciences Nervous system (semeiology, syndromes) Neurology Neuropharmacology Pharmacology. Drug treatments Psychosis Quality of life Quality of Life - psychology Risk Factors Seizures Titration zonisamide |
| title | Assessing the unmet treatment need in partial‐onset epilepsy: Looking beyond seizure control |
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