Liverpool Adverse Events Profile Scores Research Articles

A multicenter, matched case–control analysis comparing burden of illness among patients with tuberous sclerosis complex related epilepsy, generalized idiopathic epilepsy, and focal epilepsy in Germany

BackgroundDepending on the underlying etiology and epilepsy type, the burden of disease for patients with seizures can vary significantly. This analysis aimed to compare direct and indirect costs and quality of life (QoL) among adults with tuberous sclerosis complex (TSC) related with epilepsy, idiopathic generalized epilepsy (IGE), and focal epilepsy (FE) in Germany.MethodsQuestionnaire responses from 92 patients with TSC and epilepsy were matched by age and gender, with responses from 92 patients with IGE and 92 patients with FE collected in independent studies. Comparisons were made across the main QoL components, direct costs (patient visits, medication usage, medical equipment, diagnostic procedures, ancillary treatments, and transport costs), indirect costs (employment, reduced working hours, missed days), and care level costs.ResultsAcross all three cohorts, mean total direct costs (TSC: €7602 [median €2620]; IGE: €1919 [median €446], P < 0.001; FE: €2598 [median €892], P < 0.001) and mean total indirect costs due to lost productivity over 3 months (TSC: €7185 [median €11,925]; IGE: €3599 [median €0], P < 0.001; FE: €5082 [median €2981], P = 0.03) were highest among patients with TSC. The proportion of patients with TSC who were unemployed (60%) was significantly larger than the proportions of patients with IGE (23%, P < 0.001) or FE (34%, P = P < 0.001) who were unemployed. Index scores for the EuroQuol Scale with 5 dimensions and 3 levels were significantly lower for patients with TSC (time-trade-off [TTO]: 0.705, visual analog scale [VAS]: 0.577) than for patients with IGE (TTO: 0.897, VAS: 0.813; P < 0.001) or FE (TTO: 0.879, VAS: 0.769; P < 0.001). Revised Epilepsy Stigma Scale scores were also significantly higher for patients with TSC (3.97) than for patients with IGE (1.48, P < 0.001) or FE (2.45, P < 0.001). Overall Quality of Life in Epilepsy Inventory-31 items scores was significantly lower among patients with TSC (57.7) and FE (57.6) than among patients with IGE (66.6, P = 0.004 in both comparisons). Significant differences between patients with TSC and IGE were also determined for Neurological Disorder Depression Inventory for Epilepsy (TSC: 13.1; IGE: 11.2, P = 0.009) and Liverpool Adverse Events Profile scores (TSC: 42.7; IGE: 37.5, P = 0.017) with higher score and worse results for TSC patients in both questionnaires.ConclusionsThis study is the first to compare patients with TSC, IGE, and FE in Germany and underlines the excessive QoL burden and both direct and indirect cost burdens experienced by patients with TSC.

EFFICACY AND TOLERABILITY OF ESLICARBAZEPINE ACETATE AS MONOTHERAPY IN PATIENTS OF NEWLY DIAGNOSED FOCAL EPILEPSY

This study was conducted at Department of Psychiatry, Teerthanker Mahaveer University, Moradabad. The aim of our study was to determine the efficacy and safety of Eslicarbazepine Acetate, observe its well-tolerated use and monitor adverse effects in newly diagnosed patients of focal epilepsy. A total of 30 newly diagnosed cases of focal epilepsy between 18-60 years, were studied for 6 months, using a semi-structured interview and Liverpool Adverse Events Profile. Majority of patients were males (58%), between 21-30 years. Patients with partial/focal seizures (63%) were more common than those of generalized seizures (37%).Majority of the participants had 1-2 episodes of focal seizures weekly (48%), while some had almost daily (32%). Majority were on Eslicarbazepine Acetate 800mg in two divided doses daily (64%), while the others received 1200 mg in divided doses (32%). The mean Liverpool Adverse Events Profile score initially was 28.34 ± 6.28 which significantly improved after 4 weeks treatment to 22.80 ± 4.35 (p &lt; 0.05). The improvement in newly diagnosed focal seizures patients was significantly more than other patients (p &lt; 0.05).No major side effects were observed.Therefore, better results of this drug are found in newly diagnosed focal epilepsy patients.

Tolerability of antiseizure medicines using Lithuanian version of the Liverpool Adverse Events Profile

ObjectivesTo develop and validate a Lithuanian version of the Liverpool Adverse Events Profile (LT-LAEP), and to evaluate the main demographic, clinical, and pharmacological determinants of its score. Materials and methodsWe developed the LT-LAEP and examined its psychometric properties. People with epilepsy (PWE) were asked to fill in the LT-LAEP, the Generalized Anxiety Disorder scale-7 (GAD-7), the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and a questionnaire addressing key demographic and clinical information. Antiseizure medicine (ASM) burden was expressed as a number of ASM and total drug load. Multiple linear regression analysis was used to determine the influence of various variables on LAEP results. ResultsThe data of 157 participants with the established diagnosis of epilepsy and stable ASM regimen were included in the final analysis. The mean LT-LAEP score was 48.72 ± 13.65. High internal consistency (Cronbach’s α = 0.912) and test–retest reliability (ICC = 0.801) were demonstrated. The most common adverse effects (AEs) were tiredness (24.8%) and memory problems (23.6%). Lithuanian version of the Liverpool Adverse Events Profile score significantly correlated with NDDI-E (r = 0.635, p < 0.001) and GAD-7 (r = 0.640, p < 0.001) scores. The correlation between LT-LAEP score and total drug load was weak (r = 0.243, p = 0.002). The significant predictors of higher LT-LAEP score were female sex (β = −4.768, p = 0.003), higher seizure frequency (β = 4.757, p < 0.001), and higher NDDI-E (β = 1.457, p < 0.001) and GAD-7 scores (β = 0.610, p = 0.007) (F(4,152) = 43.975, R2 = 0.536, p < 0.001). ConclusionsThe LT-LAEP is a reliable and valid instrument for the evaluation of the AEs of ASM. A higher score of LT-LAEP is predicted by female sex, seizure frequency, and anxiety and depression levels rather than total drug load.

Efficacy and tolerability of eslicarbazepine acetate as monotherapy in patients of newly diagnosed focal epilepsy

IntroductionEslicarbazepine Acetate, a novel anti-epileptic drug has been approved as monotherapy in focal onset seizures, with/without secondary generalization in adults. Eslicarbazepine has many advantages over older anti-epileptic drugs and is useful in patients of new onset focal epilepsy.Objectives Aim of our study was to determine the efficacy and safety of Eslicarbazepine Acetate, observe its well-tolerated use and monitor adverse effects in newly diagnosed patients of focal epilepsy.MethodsStudy was done at Department of Psychiatry, Teerthanker Mahaveer University, Moradabad. A total of 30 newly diagnosed cases of focal epilepsy between 18-60 years of age were studied for 6 months, using a Semi-structured Interview and Liverpool Adverse Events Profile.ResultsMajority of patients were males (58%), between 21-30 years. Patients with partial/focal seizures (63%) were more common than those of generalized seizures (37%). Majority of the participants had 1-2 episodes of focal seizures weekly(48%), while some had almost daily(32%). Majority were on Eslicarbazepine Acetate 800 mg in two divided doses daily (64%), while the others received 1200 mg in three divided doses(32%). The mean Liverpool Adverse Events Profile score initially was 28.34 ± 6.28 which significantly improved after 4 weeks treatment to 22.80 ± 4.35 (p &lt; 0.05). The improvement in newly diagnosed focal seizures patients was significantly more than other patients (p &lt; 0.05). No major side effects were observed.ConclusionsEslicarbazepine Acetate as a monotherapy is effective in treating focal epilepsy. Better results of this drug are found in newly diagnosed focal epilepsy patients.DisclosureNo significant relationships.

Adverse events related to antiepileptic drugs

ObjectiveAdverse events (AEs) related to antiepileptic drugs (AEDs) may interfere with adequate dosing and patient adherence, leading to suboptimal seizure control, and relatedly, increased injuries, hospitalizations, and mortality. This study investigated the clinicodemographic factors associated with AEs related to AEDs as reported by the Liverpool Adverse Events Profile (LAEP), and explored the ability of LAEP to discriminate between epilepsy and psychogenic nonepileptic seizures (PNES). We hypothesized that female sex, mood disorders, AED-polytherapy, duration, and severity of epilepsy are associated with increased endorsement of AEs related to AEDs, and that endorsement of AEs related to AEDs would significantly differ between epilepsy and PNES patients. MethodsWe prospectively enrolled adult patients admitted to two inpatient video-electroencephalogram monitoring units. Clinicodemographic variables and psychometric measures of depression, anxiety, and cognitive function were recorded. Patient-reported AE endorsement was obtained using the LAEP, which was reduced to four latent domains using exploratory structural equation modeling. General linear models identified variables associated with each domain. Logistic regression determined the ability of LAEP scores to differentiate between epilepsy and PNES. Results311 patients met inclusion criteria. Mean age was 38 years and 56% of patients were female. Network analysis demonstrated strong relationships between depression and anxiety with physical, sleep, psychiatric, and dermatological AE endorsement. Depression, female sex, and AED polytherapy were associated with greater AE endorsement. Epilepsy, compared to PNES, was associated with lower AE endorsement. Fewer prescribed AEDs and greater reported physical AE endorsement were associated with PNES diagnosis. SignificanceThere is a strong relationship between patient-reported AEs and psychiatric symptomatology. Those with PNES paradoxically endorse greater physical AEs despite receiving fewer AEDs. Patients who endorse AEs in clinical practice should be screened for comorbid depression or anxiety and treated accordingly.

Usefulness of the Liverpool Adverse Events Profile for predicting a high risk of suicidality in people with drug-resistant epilepsy

PurposeSuicidality including suicidal ideation and attempt has been a critical issue in people with epilepsy, especially in people with drug-resistant epilepsy (PWDRE). Clinicians commonly ask about adverse effects of antiepileptic drugs (AEDs) using something like the Liverpool Adverse Events Profile (LAEP) at epilepsy clinics, but suicide is usually not of interest. A high risk of suicidality can increase mortality by committing suicide in PWDRE. This study aimed to investigate whether clinicians can discern a high risk of suicidality in PWDRE by referring to the LAEP. MethodsWe recruited PWDRE, aged from 19 to 68. They completed the 21-item LAEP, the suicidality module of the Mini International Neuropsychiatric Interview, and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Through receiver operating characteristic curve analysis, we tested the usefulness of LAEP to detect a high risk of suicide. By this, we determined each cutoff point of the total LAEP score and the number of severe LAEP items, for detecting the risk. ResultsA hundred forty-four PWDRE participated in this study. Among them, 36 PWDRE (25.0%) had a high risk of suicidality. Either >45 of the total LAEP score or >8 of the number of severe LAEP items was a suggested optimal cutoff point for discerning the high risk of suicidality. LAEP had a correlation with the suicidality item of the NDDI-E. ConclusionThe LAEP may inform a high risk of suicidality in PWDRE. Referring to this, clinicians can discern suicidal problems in their epilepsy clinics.

Validity of the Liverpool Adverse Events Profile as a Screening Tool for Detecting Comorbid Depression or Anxiety Disorder in People with Epilepsy.

Background and PurposeThe Liverpool adverse events profile (LAEP) is useful for detecting and monitoring the adverse effects of antiepileptic drugs (AEDs) and contains items related to symptoms of depression or anxiety. This study evaluated the usefulness of the LAEP for detecting comorbid depression or anxiety disorder in people with epilepsy (PWE).MethodsPWE, aged from 18 to 70 years and who took AEDs for at least 1 year, were included. They completed the Korean version of the LAEP (K-LAEP) to detect the adverse effects of AEDs and the mini international neuropsychiatric interview-plus version 5.0.0 (MINI) to identify major depressive disorder (MDD) and generalized anxiety disorder (GAD). We validated the K-LAEP as a screening tool for coexisting MDD or GAD in PWE. Receiver operating character (ROC) curve analyses were used to measure the appropriateness of cutoff scores for the total and item K-LAEP scores for detecting MDD or GAD.ResultsThe study enrolled 150 PWE. According to the MINI, 30 PWE (20.0%) had MDD and 26 (17.3%) had GAD. Cronbach’s α coefficient of the K-LAEP was 0.939. For the total K-LAEP score, cutoff scores of 40 and 43 could detect MDD and GAD, respectively. For the K-LAEP item score, a cutoff of five could detect MDD or GAD.ConclusionsThe K-LAEP is a valid screening tool for detecting MDD and GAD in PWE. A high LAEP score suggests comorbid psychiatric disorders, which need further specific evaluation.

The impact of old versus new antiepileptic drugs on costs and patient reported outcomes among older adults

The aim of this prospective questionnaire-based cross-sectional study was to examine whether the new generation of Antiepileptic drugs (AEDs) with higher acquisition cost generate lower adverse effects than the old AEDs among a sample of 102 Arabic-speaking older adults (60 years of age or older) with seizure disorders. The mean scores of the Arabic version of the Liverpool Adverse Events Profile (LAEP), which assessed the adverse effects of the AEDs, did not differ between patients taking the old and new generations of AEDs. Despite their 4-fold higher cost, the new generation of AEDs were not characterized by lower LAEP scores of adverse effects. However, higher LAEP scores were associated with better health literacy. In conclusion, the use of new AEDs was not associated with lower self-reported adverse effects scores among Arabic-speaking older adults with seizure disorders despite their higher acquisition costs.

Computer-based monitoring and evaluation of epilepsy-related health variables and their impact on treatment decision

ObjectiveThis study aimed to determine the effectiveness of electronic patient-reported outcomes (ePROs) with focus on epilepsy-specific quality of life, psychiatric and psychosocial burden, drug side effects, and patient satisfaction via the Computer-based Health Evaluation System (CHES) and to evaluate their impact on treatment regimen. MethodsForty consecutive patients with drug-resistant focal epilepsy undergoing prolonged video-electroencephalography (EEG) monitoring at the Department of Neurology, Innsbruck Medical University were included and randomized to an intervention group (questionnaire results accessible to the physicians) and a control group (questionnaire results inaccessible to the physicians). Patients had to complete questionnaires on the day of admission (T0) and the day of discharge (T1). ResultsOverall, twenty-five patients (25/40, 62.5%) showed abnormal assessment results, twelve of them exclusively due to pathological scores on the Liverpool Adverse Events Profile (LAEP). Mean LAEP score was within the pathological range of 48.8 points (48.8 ± 7.2). The psychosocial burden with respect to the Performance, Socio-Demographic Aspects, Subjective Evaluation (PESOS) scale “fear” (48.7 ± 21.4) was also moderately affected. Moreover, mean anxiety (9.1 ± 4.4) and depression (7.6 ± 4.5) scores were both slightly abnormal. Quality of life (as measured using the Quality of Life Inventory in Epilepsy (QOLIE-31)) was moderately impaired (seizure worry: 46.5 ± 21.3, overall quality of life: 52.6 ± 18.6, well-being: 54.1 ± 16.3, energy–fatigue: 39.4 ± 14.7, cognitive functioning: 41.4 ± 19.5, medication effects: 46.2 ± 23.4, social functioning: 51.1 ± 20.8, and total score: 47.2 ± 12.3). Careful medical history-taking and patient–physician consultations alone failed to detect needs for psychological/psychiatric help in three out of 7 patients in the control group (42.8%). Changes over time in Hospital Anxiety and Depression Scale (HADS) and QOLIE-31 scores were not significant. ConclusionThe use of ePROs was feasible and well accepted in the clinical setting. Treatment-associated adverse effects were the most frequently reported health-related restrictions. In particular, psychometric evaluation by applying ePROs can detect health-related problems in patients with epilepsy.

Arabic translation and cultural adaptation of Liverpool Adverse Events Profile (LAEP) among a sample of epileptic older adults

Purpose: To validate and culturally adapt Liverpool Adverse Events Profile (LAEP) in Arabic among a sample of elderly patients with epilepsy.Methods: The face and content validity of the Arabic version of LAEP was ensured by a group of healthcare professionals. Undemented elderly patients (≥ 60 years) with seizure disorders, who are on a single antiepileptic drug (AED), were recruited from two tertiary care centers in Riyadh, Saudi Arabia. Factor analysis was performed to check the construct validity. The reliability was measured using Cronbach’s alpha method.Results: Seventy-four patients met the inclusion criteria and were interviewed. Most of the participants had generalized seizures (67.57 %), and were either illiterate or with elementary school education (62.16 %). Their mean age was 68.9 years, and 51.35 % were male. About two-thirds of the participants were on either carbamazepine or levetiracetam (66.22 %). Six factors were extracted from the Arabic version of LAEP. Cronbach’s alpha of the Arabic version of LAEP was 0.84. The mean overall LAEP score was 28.9.Conclusion: The Arabic version of LAEP demonstrates good validity and reliability. Similar studies should examine its validity and reliability among different epileptic patient populations.Keywords: Adverse drug event, Epilepsy, Older adults, Cronbach’s alpha, Liverpool Adverse Events Profile, Seizure disorders, Carbamazepine, Levetiracetam

Epilepsy and adverse quality of life in surgically resected meningioma.

Meningiomas are common intracranial tumors, and despite surgery or therapy with anti-epileptic drugs (AEDs), many patients suffer from seizures. Epilepsy has a significant impact on quality of life (QoL) in non-tumor populations, but the impact of epilepsy on QoL in patients with meningioma is unknown. Our aim was to evaluate the impact of epilepsy on QoL in patients that have undergone resection of a benign meningioma. We recruited meningioma patients without epilepsy (n=109), meningioma patients with epilepsy (n=56), and epilepsy patients without meningioma (n=64). QoL was measured with the Short Form 36 version 2 (SF-36), the Functional Assessment of Cancer Therapy (FACT-BR), and the Liverpool Adverse Events Profile (LAEP). Regression analyses identified significant determinants of QoL. Patients with meningioma and epilepsy had poorer QoL scores than meningioma patients without epilepsy in all measures. In FACT-BR, this difference was significant. Multiple regression analyses demonstrated that current AED use had a greater impact on QoL scores than recent seizures. Other variables associated with impaired QoL included depression, unemployment, and meningioma attributed symptoms. Epilepsy has a negative impact on quality of life in patients with benign meningioma. AED use is correlated with impaired QoL and raised LAEP scores, suggesting that AEDs and adverse effects may have led to impaired QoL in our meningioma patients with epilepsy. The severity of epilepsy in our meningioma population was comparatively mild; therefore, a more conservative approach to AED therapy may be indicated in an attempt to minimize adverse effects.

Relation of Perceived Stigma to Adverse Events of Medications in Patients with Epilepsy

Purpose. We aimed to assess the influence of adverse events (AEs) of antiepileptic drugs (AEDs) on perceived stigma of Bulgarian patients with epilepsy. Methods. Our study was based on questionnaires (Liverpool Adverse Events Profile (LAEP) and stigma scale), information from medical documentation, and an interview on clinical factors of 153 consecutive patients with epilepsy. Results. Perceived stigma was observed in 64.71% of the study participants. There was a significant association between perceived stigma and the total LAEP score (p < 0.05, F = 13.71). Patients who reported AEs had an increased risk of perceiving stigma compared to those who did not experience AEs. A significant correlation between perceived stigma and the presence of neurological and psychiatric AEs (p < 0.001, r = +0.60) and a mild correlation between perceived stigma and the presence of nonneurological AEs (p < 0.01, r = +0.20) were verified. In a multivariate regression analysis the only predictors of perceived stigma were AED polytherapy and the presence of neurological and psychiatric AEs. Conclusions. AEs of AEDs in patients with epilepsy significantly correlate with perceived stigma. Our study results will be useful in the campaign to overcome stigma predictors.

Medication side effects among people with epilepsy taking phenobarbital in Zambia

Phenobarbital remains one of the most widely used antiepileptic drugs worldwide, yet there are limited data regarding side effects associated with its use in routine clinical care settings in low-income countries. Available data suggests that phenobarbital is as effective as other first-line drugs for treating tonic-clonic seizures, but side effect reports differ widely between high and low-income settings. A better understanding of phenobarbital side effect profile and severity in low-income settings is warranted given its role in efforts to decrease the epilepsy treatment gap. We used the Liverpool adverse events profile (LEAP) to assess side effects in consecutive patients with epilepsy on phenobarbital seeking care in rural Zambia. Data regarding age, gender, medication dose, and medication adherence were also collected. T-tests and Spearman's correlation coefficient were used to assess predictors of LEAP score and medication adherence. Thirty-five patients receiving a mean dose of 2.1mg/kg/day (SD: 2.78 mg/kg/day) of phenobarbital were assessed. All participants reported at least one side effect in the previous four weeks with a median of 6 symptoms (IQR: 4-8) and a mean side effects score of 28/76 (SD: 5.38). Over half reported sleepiness and dizziness. Memory problems and depression were also common (both 46%). Total LAEP score was not associated with age (p=0.88), gender (p=0.17), or phenobarbital dose (p=0.13). Medication adherence was not associated with side effects total score (p=0.56). Rural Zambian adults taking phenobarbital at doses recommended by the World Health Organization report a significant number of side effects. The most common side effects reported were similar to those reported in high-income countries. The significant burden of phenobarbital-associated side effects in this African cohort is in contrast to data from non-randomized clinical trials in China that reported phenobarbital to be well-tolerated with few side effects. Additional investigations regarding phenobarbital side effects during routine care in low income settings is warranted.

Is antiepileptic drug withdrawal status related to quality of life in seizure-free adult patients with epilepsy?

PurposeThis study aimed to determine factors that influence the quality of life (QOL) of seizure-free adult patients with epilepsy in western China and address whether these determinants vary by antiepileptic drug (AED) withdrawal. MethodsA cross-sectional study was conducted in the epilepsy outpatient clinic of West China Hospital, Sichuan University. Patients with epilepsy who were aged at least 18years and seizure-free for at least 12months were interviewed using the Quality of Life in Epilepsy Inventory-31 (QOLIE-31); the National Hospital Seizure Severity Scale (NHS3); the Liverpool Adverse Events Profile (LAEP); the Social Support Rating Scale (SSRS); the Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) Questionnaire; and the Scale of Knowledge and Attitudes Toward Epilepsy. Eligible patients were divided into two groups: the nonwithdrawal group and the withdrawal group. The independent-samples t-test was used to compare the QOL between the groups, and linear regression analysis was used to explain the variance of their QOL. ResultsOne hundred and eighty-seven (135 nonwithdrawal and 52 withdrawal) patients were included in the analysis. The QOLIE-31 overall score of the nonwithdrawal group was lower than that of the withdrawal group (p<0.01). The LAEP score was the strongest predictor of the QOLIE-31 overall score of all subjects, explaining 26.9% of the variance. The second strongest predictor was the SSRS score, explaining 12.9%, and the other predictors were the NHS3 score (5.2%), education level (2.3%), age (1.5%), and marriage (1.0%). Furthermore, the strongest predictors in the nonwithdrawal group were the LAEP and SSRS scores, while in the withdrawal group, the strongest predictors were stigma scores and employment. ConclusionAmong the seizure-free adult patients with epilepsy, those with AED withdrawal experienced better QOL than those continuing AED treatment. Furthermore, the determinants of QOL varied by AED withdrawal. Individual strategies to optimize QOL should be developed based on these differences.

Severity of anxiety and depression are related to a higher perception of adverse effects of antiepileptic drugs

After reviewing the negative effects of antiepileptic drugs (AEDs) on general health and quality of life, the Commission on Outcome Measurement from the International League Against Epilepsy (ILAE) recommended incorporating reliable and valid tools in clinical essays in order to achieve a more accurate assessment of the subjective adverse effects rate and disease severity when using AEDs. PurposeThe aim of this study was to correlate the severity of adverse effects of AEDs, with the presence of anxiety and depression in patients with epilepsy. MethodsThe Spanish version of the Liverpool Adverse Events Profile (LAEP) and the Hospital Anxiety and Depression Scale (HADS) were applied on 130 consecutive outpatients with epilepsy from the epilepsy clinic at the Mexico's National Institute of Neurology and Neurosurgery. A correlation analysis was carried out to determine if the presence of depression and anxiety was related to the adverse effects of AEDs. The relation between LAEP scores with other epidemiological variables was also assessed. ResultsOur study found a positive correlation between the LAEP and the HADS scores (p=<0.01).The most common adverse effects were drowsiness (81.5% [n=106]), difficulty in concentrating (76% [n=99]), and nervousness and/or agitation (75% [n=97]). Female gender, a history of febrile seizures, persistent seizures and polytherapy were associated with a higher toxicity on LAEP. In our study, age at epilepsy onset, duration of epilepsy, type of epilepsy and patients’ age were not related to higher LAEP scores. ConclusionAdverse effects to AEDs can be related with the presence of psychiatric disorders such as anxiety and depression in patients with epilepsy.

Are adverse effects of antiepileptic drugs different in symptomatic partial and idiopathic generalized epilepsies? The Portuguese–Brazilian validation of the Liverpool Adverse Events Profile

We report the results of administration of the Portuguese–Brazilian translation of the Liverpool Adverse Events Profile (LAEP) to 100 patients (mean age=34.5, SD=12.12; 56 females), 61 with symptomatic partial epilepsy (SPE) and 39 with idiopathic generalized epilepsy (IGE) (ILAE, 1989) who were on a stable antiepileptic drug (AED) regimen and being treated in a Brazilian tertiary epilepsy center. Carbamazepine was the most commonly used AED (43.0%), followed by valproic acid (32.0%). Two or more AEDs were used by 69.0% of patients. The mean LAEP score (19 questions) was 37.6 (SD=13.35). The most common adverse effects were sleepiness (35.0%), memory problems (35.0%), and difficulty in concentrating (25.0%). Higher LAEP scores were associated with polytherapy with three or more AEDs (P=0.005), female gender (P<0.001), older age (P<0.001), and uncontrolled seizures (P=0.045). The intraclass coefficient (test–retest reliability) for LAEP overall score was 0.848 (95% CI=0.782–0.895), with a range from 0.370 (unsteadiness) to 0.750 (memory problems). Cronbach's α coefficient (internal consistency) was 0.903. The LAEP was highly correlated with Quality of Life in Epilepsy-31 inventory (r=−0.804, P>0.001) and Hospital Anxiety and Depression Scale (Depression: r=0.637, P<0.001; Anxiety: r=0.621, P<0.001) dimensions. LAEP overall scores were similar in people with SPE and IGE and were not helpful in differentiating adverse effects in these two groups. Clinical variables that influenced global LAEP were seizure frequency (P=0.050) and generalized tonic–clonic seizures in the last month (P=0.031) in the IGE group, and polytherapy with three or more AEDs (P=0.003 and P=0.003) in both IGE and SPE groups.

Validation of the Chinese version of the Liverpool Adverse Events Profile in patients with epilepsy

The objective of the study was to validate the Chinese version of The Liverpool Adverse Events Profile (LAEP) in patients with epilepsy. The scale was translated from the English version into a Chinese version and was then back-translated to examine its accuracy. Content validity, concurrent validity, and construct validity were then used to examine the overall validity of this scale. A cross-sectional design with convenience sampling was used to recruit participants from three medical centers. The LAEP Chinese version was tested with respect to validity and reliability in 357 patients with epilepsy, and another 28 patients were invited to evaluate the test-retest reliability of the scale in a 2-week interval. There was a good content validity index (CVI=1.0). Patients undergoing polytherapy had more adverse effects (χ(2)=6.10, p<0.01) and higher LAEP scores (t=-2.91, p<0.01) than patients undergoing monotherapy, indicating a good concurrent validity. Factor analysis included three factors classified by symptoms in the 22-item Chinese version of the LAEP. The total variance of these three factors was 39.3% for the scale. Internal consistency (Cronbach's α=0.92) and the intraclass correlation coefficient (ICC=0.80) were satisfactory. Moreover, the LAEP can be completed in a short time, is perceived as easy to complete, and there was no relevant information missing. The results indicated that the Chinese version of the LAEP yielded highly acceptable parameters of validity and reliability and can be used for measuring adverse effects of antiepileptic drugs among Chinese-speaking patients with epilepsy in Taiwan.

Validation of the Spanish version of the Liverpool Adverse Events Profile in patients with epilepsy

The objective of the study was to validate the Spanish version of the Liverpool Adverse Events Profile (LAEP). An observational, cross-sectional, multicenter study was carried out on patients with epilepsy treated with a stable dose of antiepileptic drugs. Patients completed the LAEP, Quality of Life in Epilepsy Inventory-31 (QOLIE-31), and Hospital Anxiety and Depression Scale (HADS). Two hundred sixty-six patients were recruited. The LAEP was completed in a short time, perceived as easy to complete, and there was no relevant information missing. Ceiling/floor effects were negligible. Internal consistency (Cronbach’s α = 0.84) and test–retest reliability (ICC = 0.81) were satisfactory. LAEP scores consistently correlated with QOLIE-31 ( r = 0.71) and HADS ( r = 0.52–0.63) scores. When the LAEP was used to discriminate between patients with and without adverse events, the scores on the QOLIE and HADS corresponded. The Spanish version of the LAEP scale exhibits adequate psychometric properties, suggesting that it is an appropriate instrument to measure adverse events among Spanish-speaking patients with epilepsy.

The Liverpool Adverse Events Profile: Relation to AED Use and Mood

The Liverpool Adverse Events Profile (LAEP) is used as a systematic measure of adverse effects from antiepileptic drugs (AEDs). This study evaluated LAEP in newly diagnosed seizure patients, and examined the relation between LAEP, anxiety, and depression. Seizure patients seen in the two First Seizure Clinics were categorized into group A (AEDs commenced after assessment), group B (AEDs commenced before assessment), and group C (no AEDs). LAEP and the Hospital Anxiety and Depression Scale (HADS) were completed at baseline (n=164) and 3 months (n=103). Each LAEP symptom was assessed for baseline frequency, 3-month frequency, and frequency change over a 3-month period. Global scores for LAEP and HADS were analysed at baseline and 3 months. Symptom-reporting patterns were similar between groups. However, increased frequency over a 3-month period occurred for 12 symptoms in group A, 10 in group B, and one in group C. Global LAEP and HADS showed no significant group differences at baseline or changes over a 3-month period. Multiple regression revealed that HADS scores predicted LAEP global scores better than did AED status. Multivariate analyses of variance demonstrated that increased reporting of 16 of 19 LAEP symptoms was significantly related to higher anxiety and depression rates. In a First Seizure Clinic, LAEP detects changes in specific symptom frequencies when used as a repeated, symptom-by-symptom measure. Increased symptom frequency is associated with diagnostic category/AED treatment, anxiety, and depression. Global LAEP scores do not illustrate differences in symptom reporting between patients.