Anti-Epileptic Drug Toxicity in Children.

Imti Choonara

doi:10.3390/children5050057

Abstract

Anti-epileptic drugs (AEDs) have had a major impact on children, improving their quality of life and significantly reducing both morbidity and mortality. They are, however, associated with significant toxicity. Behavioural problems and somnolence are the most frequent adverse drug reactions for many AEDs. Unfortunately, the comparative risk of drug toxicity for different AEDs has been inadequately studied. Drug toxicity is poorly reported in randomised controlled trials. Prospective cohort studies are the best way to study drug toxicity. There have been a few prospective cohort studies of children with epilepsy, but the numbers of children have been small. Systemic reviews of the toxicity of individual AEDs have been helpful in identifying the risk of drug toxicity. Parents of children with epilepsy and the children and young people who are due to receive AED treatment have the right to know the likelihood of them experiencing drug toxicity. Unfortunately, the evidence base on which health professionals can provide such information is limited.

Highlights

Epilepsy is the most common neurological disorder in children, affecting approximately 1 in 200 children
Monotherapy is the recommended treatment as it minimises adverse drug reactions (ADRs) and a systematic review showed that the majority of children with epilepsy received monotherapy [1]
Parents of children with epilepsy and the children and young people who are due to receive Anti-epileptic drugs (AEDs) treatment have the right to know the likelihood of them experiencing an ADR, the types of ADRs they are likely to experience alongside when they should contact a health professional if they suspect they are experiencing an ADR

Summary

Introduction

Epilepsy is the most common neurological disorder in children, affecting approximately 1 in 200 children. A recent large study in the USA suggested that levetiracetam was the most widely-used AED in children with epilepsy, with more than one in four children receiving levetiracetam [2]. Monotherapy is the recommended treatment as it minimises adverse drug reactions (ADRs) and a systematic review showed that the majority of children with epilepsy received monotherapy [1].

Results

Conclusion