Determining risk factors of developing adverse effects of antiepileptic drugs in epileptic patients

Abstract

Adverse effects (AE) of antiepileptic drugs (AEDs) are common in daily neurological practice. Ensuring that an AE is attributable to an AE and predicting its occurrence remain a challenge. Our aim was to investigate the predictors of AE of AEDs in epileptic patients. We conducted a cross-sectional study at the department of Neurology at Razi hospital (Tunisia), from January 2016 to June 2016. All epileptic patients on AEDs for at least 6 months during the study period were screened for inclusion. Demographic, clinical characteristics, AED regimen and associated AE were recorded. Risk factors for developing AE were assessed. We included 54 epileptic patients with AEDs-related AE were included. Sex ratio was 1.34. Mean age was 36.5 years and mean disease duration was 19 years. About 46% were on monotherapy. Valproate (72%) and Cabamazepine (44%) were the most frequently prescribed AED regardless of regimen. Acute, dose-dependent reactions (neurologic (28.84%) and gastrointestinal symptoms (10.84%)) were the most common AE, followed by hematologic idiosyncratic reactions (14.43%). Increased duration of the disease (p = .014), high frequency of initial seizures (p = .001), patients with interictal EEG abnormalities (P = .005), polytherapy (p = .009), and those receiving carbamazepine (p = .007) and high doses of valproate intake (p = .023) were found to be at higher risk of experiencing AE. Both disease characteristics and AED patterns were found to be determinants in AE development. Clinicians should be aware of these factors when monitoring patients to minimize the risk and to improve compliance.