Abstracts

Rationale: Adverse events to antiepileptic drugs (AEDs) can significantly affect the life of children with epilepsy. Young children are often more sensitive to AED effects and need special consideration in relation to prescribing and titrating these drugs. The primary objective of our study was to evaluate the incidence and pattern of adverse reactions to AEDs in pediatric epileptic patients, including newer AEDs. Methods: We reviewed retrospectively the medical records of children younger 18 years of age treated at four tertiary care teaching hospitals in Daejeon and Chungcheong area, during January 2009 to December 2013. AED-associated ADRs, demographic and clinical characteristics, and causality, assessed by the World Health Organization-Uppsala Monitoring Center Scale, were recorded. Results: A total of 772 children on AED therapy were screened, of which 50 children (6.5%) experienced 1 or more ADRs, and were enrolled in the study. Of the included children, 27 (54%) were boys, with a mean age of 9.9 years (range, 2 months - 17.7 years). The mean duration of epilepsy was 11.4 ± 17.3 months, and 18% children had symptomatic epilepsy. More than two-third of children were on monotherapy, with oxcabazepine (28%) and topiramate (22%) being the most common AEDs. Skin rash (32%) was the most common ADR, followed by somnolence (10%), dizziness (8%), cognitive decline (8%), violent behavior (8%), and others. Fourty ADRs were certain or probable, and 10 ADRs were possible. AEDs were withdrawn in 28 children and skin rash (43%) was most common ADRs. Conclusions: Major findings of our analysis are as follows; Oxcarbazepine was the most common ADR causative agent (28%). Skin rash (32%) was the most common ADR, causing by oxcarbazepine and lamotrigine. Most ADRs had certain or probable causalities (86%). Relatively, AEDs were highly withdrawn in 58%, skin rash being most common ADRs. In conclusion, adverse events to AEDs, especially new-generation drugs, were very common among epileptic population in children. Careful monitoring and the systematic tracking of ADRs may lessen another burden among children receiving AEDs.