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Younger children more prone to experience behavioural side effects of AED

29 Nov 2017

Younger children appear to be more likely to experience behavioural side effects of antiepileptic drugs (AEDs), with the likelihood increasing if children with epilepsy have baseline hyperactivity/impulsivity, a retrospective study has found.

A total of 380 youths (mean age 8.9 years; 83.4 percent Caucasian) with new-onset epilepsy were included in the study. The Behavior Assessment System for Children, 2nd Edition: Parent Rating Scale and the Pediatric Epilepsy Side Effects Questionnaire were completed by the youths’ caregivers to obtain data on psychological functioning at baseline and identify AED behavioural side effects at the 1-month follow-up following AED initiation. Children (aged 2 to 11 years) and adolescents (aged 12 to 18 years) were separately evaluated.

In the population, 34.8 percent had focal epilepsy, 41.1 percent had generalized epilepsy and 23.7 percent had unclassified epilepsy. Majority (70 percent) had at-risk or clinically elevated baseline psychological symptoms.

Behavioural side effects of AEDs occurred with greater frequency in children than in adolescents (25.08 vs 12.36), regardless of the drug used. Valproic acid was associated with significantly greater behavioural side effects compared with all other AEDs, except for levetiracetam.

In both age groups, higher hyperactivity/impulsivity at baseline emerged as significant predictor of higher behavioural side effects 1 month after AED initiation.

The present data show that AED tolerability is better among older than younger children, with valproic acid being a more challenging AED across the age spectrum, researchers pointed out, adding that baseline psychological screening, specifically hyperactivity, can be used as a precision medicine tool for AED selection.

“When baseline psychological symptoms are present, particularly hyperactivity/impulsivity, providers may consider avoiding AEDs with greater potential for psychotropic effects to increase tolerability for the patient and family early in the course of treatment, along with decreasing the need for multiple AED trials due to problematic side effects. If unavoidable, caregivers may benefit from anticipatory guidance on managing behavioural side effects,” researchers said.

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Most Read Articles
Pearl Toh, Yesterday
First-line therapy with the BTK* inhibitor ibrutinib plus the anti-CD20 immunotherapy rituximab confers significant survival advantage over the current gold-standard regimen of fludarabine, cyclophosphamide, and rituximab (FCR) for young, fit patients with treatment-naïve chronic lymphocytic leukaemia (CLL), according to the E1912 trial, a large cooperative group study supported by the US National Cancer Institute.
Rachel Soon, 05 Dec 2018

At the recent Malaysian Community Pharmacy Business Forum (MyCPBF), a discussion forum was held on the subject of “Transcending Primary Healthcare Services: The Future of Specialized Pharmacy Services and Pharmacy Specialization”.

Dr Renly Lim, 01 Aug 2018
Palliative care uses an integrated, multidisciplinary approach to reduce suffering and to improve the quality of life of patients battling with life-threatening illnesses.
Rachel Soon, 01 Mar 2018

Over half of consumers who use herbal supplements still do not inform physicians of their practices in consultation, according to a local study.