Strategies for Optimizing Antiepileptic Drug Therapy in Elderly People

  title={Strategies for Optimizing Antiepileptic Drug Therapy in Elderly People},
  author={Thomas E. Lackner},
  journal={Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
  • T. Lackner
  • Published 1 March 2002
  • Medicine, Psychology
  • Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
The elderly take more antiepileptic drugs (AEDs) than all other adults. This extensive use directly correlates with an increased prevalence of epilepsy in a growing population of older people, as well as other neuropsychiatric conditions such as neuropathic pain and behavioral disorders associated with dementia and for which AEDs are administered. The agents account for nearly 10% of all adverse drug reactions in the elderly and are the fourth leading cause of adverse drug reactions in nursing… 

Choice of antiepileptic drugs for the elderly: possible drug interactions and adverse effects

In order to make further recommendations regarding the choice and dosing regimens of antiepileptic drugs in elderly patients, more extensive clinical research in this specific population is necessary.

Optimizing Antiepileptic Drug Therapy in the Elderly

  • W. Garnett
  • Medicine
    The Annals of pharmacotherapy
  • 2005
OBJECTIVE To review and evaluate the medical literature concerning antiepileptic drug (AED) therapy in elderly patients. DATA SOURCES A MEDLINE search (1982–December 2004) was conducted.

Overtreatment in adults with epilepsy

  • C. Deckers
  • Medicine, Psychology
    Epilepsy Research
  • 2002

Seizure disorders in the elderly.

The goal of antiepileptic drug therapy is to control seizures but preserve quality of life, and drugs for first-line monotherapy of seizures in elderly patients include carbamazepine, valproic acid, oxcarbazepine and gabapentin.

Antiepileptic Drugs and Accumulation of Hospital Days Among Persons With Alzheimer's Disease.

Adverse drug reactions in elderly patients.

Age itself should not be used as a reason for withholding adequate doses of effective therapies, and the clear risk of ADRs in this situation should be considered in the context that dose-related failure of existing therapy to manage the condition adequately may be one of the most important reasons for admission of the elderly to hospital.

Management of epilepsy in pediatrics and geriatrics.

  • C. PoonJ. McAuley
  • Medicine, Psychology
    Journal of the American Pharmaceutical Association
  • 2002
Three rare but important conditions among infants and children--pyridoxine-deficiency seizures, Lennox-Gastaut syndrome, and West syndrome--usually require multidrug therapy to control seizures.

Medication-related dizziness in the older adult.

Safety issues around misuse of antiepileptics

The prevalence of misuse of antiepileptic drugs among epileptic patients is comparable to that observed in other chronically ill individuals and Preventive strategies have to be based on the reasons leading to nonadherence.



Antiepileptic drug therapy in the elderly.

Use of antiepileptic drugs in the elderly population.

Medical records for 572 patients in two extended care facilities were reviewed to study seizure disorders and antiepileptic drug use and Phenytoin was the most commonly used agent.

Drug-Induced Seizures in the Elderly

A review of drugs that were most commonly associated with inducing seizures in the elderly population and which classes of medications and individual medications are associated with reducing seizure threshold is conducted.

Pharmacologic Advantages of Antiepileptic Drug Monotherapy

There are patients who may respond better to AED combinations, but the number is relatively small and, in some cases, the improvement in seizure control produced by an added AED may be more than offset by an excessive burden of side effects.

Antiepileptics in the elderly. Pharmacoepidemiology and pharmacokinetics.

An understanding of the underlying pharmacokinetic processes, including the need of most elderly patients for lower doses and longer dosing intervals, permits more effective management of therapy and reduces the risk for adverse reactions.

Cognitive and behavioral effects of antiepileptic drugs

Overview of the Safety of Newer Antiepileptic Drugs

The potential for the most recently developed AEDs for producing rare idiosyncratic reactions cannot be ascertained until additional patient exposures have been reported from careful postmarketing surveillance.

Epidemiology, etiology, and treatment of geriatric mania.

  • W. McDonald
  • Medicine, Psychology
    The Journal of clinical psychiatry
  • 2000
The treatment of mania is more difficult in the elderly, and new treatments such as the atypical antipsychotics and the anticonvulsants take on a more important role in treatment regimens for older patients.

Adverse Reactions to New Anticonvulsant Drugs

The relatively late establishment of aplastic anaemia and hepatic failure as potentially fatal ADRs of felbamate, and of visual field constriction with vigabatrin, should serve as ample reminders that ADRs can appear at any time.