Chapter 20
Prevention and Management of Side-effects of Antiepileptic Drugs
Gaetano Zaccara, Piero Perucca,
Piero Perucca
The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
Search for more papers by this authorGaetano Zaccara, Piero Perucca,
Piero Perucca
The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
Search for more papers by this authorBook Editor(s):Simon Shorvon MA MB BChir MD FRCP,
Emilio Perucca MD PhD FRCP(Edin),
Jerome Engel Jr. MD PhD,
Simon Shorvon MA MB BChir MD FRCP
Professor in Clinical Neurology and Consultant Neurologist
UCL Institute of Neurology, University College London, National Hospital for Neurology and Neurosurgery, London, UK
Search for more papers by this authorEmilio Perucca MD PhD FRCP(Edin)
Professor of Medical Pharmacology and Director, Clinical Trial Center
Clinical Pharmacology Unit, Department of Internal Medicine and Therapeutics University of Pavia, C. Mondino National Neurological Institute Pavia, Italy
Search for more papers by this authorJerome Engel Jr. MD PhD
Jonathan Sinay Distinguished Professor of Neurology and Director UCLA Seizure Disorder Center
Neurobiology, and Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, USA
Search for more papers by this authorSummary
Adverse effects are a major deterrent to successful treatment with antiepileptic drugs (AEDs). Adverse effects can be classified in different ways. Using a modified version of the World Health Organization (WHO) classification, adverse effects of AEDs can be distinguished into five types: type A (acute, related to known mechanism of action of the drug); type B (idiosyncratic); type C (chronic); type D (delayed); and type E (secondary to drug interactions). This chapter discusses the effects of types A, B and C. Before prescribing a drug, the adverse effect profile should be tailored to the characteristics of the individual patient. For prevention measures to be effective, a therapeutic alliance between the clinician and the patient is necessary. The chapter also talks about medical and psychiatric comorbidities, central nervous system (CNS) dose-dependent adverse effects, titration rates, and serum drug concentrations.
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