Antiepileptic Drug and Psychotropic Agent Combinations Used in Epilepsy Patients with Developmental Disabilities
Abstract number :
3.130
Submission category :
Year :
2001
Submission ID :
2831
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
D.N. Risbrook, FNP, Neurology, LIJ Comprehensive Epilepsy Center, New Hyde Park, NY; C. Smith, PharmD, Pharmacy, LIJMC, New Hyde Park, NY; D. Kolesnik, MD, Neurology, Long Island Jewish Comprehensive Epilepsy Center, New Hyde Park, NY; A.E. McBride, MD, N
RATIONALE: Psychotropic agents are frequently prescribed in patients with developmental disabilities (DD) and epilepsy; yet clinicians may not focus proper attention on potentially important drug interactions.
METHODS: We reviewed the records of 30 patients with DD and epilepsy, recently evaluated at our tertiary epilepsy center, and surveyed the nature of antiepileptic drugs (AEDs) and psychotropic agents administered over the past year.
RESULTS: Ten patients (33%) received both an AED and a psychotropic medication. Of these 10 patients, 5 patients (50%) received specific AED psychotropic combinations that have been documented to have drug interactions. Examples were combinations of microsomal CYP-inducing AEDs such as carbamazepine or phenytoin in combination with psychotropic agents such as fluoxetine or olanzepine, with the former group potentially raising the dosage requirement of the latter drugs. Other drug combinations in our patients involved psychotropic agents potentially reducing the metabolism of the AEDs. There were also possible effects on protein binding. Four patients were on multiple AEDs that had the potential of interacting with each other.
CONCLUSIONS: Clinicians need to be aware of potential drug interactions among AEDs and psychotropic medications that are frequently prescribed in patients with DD and epilepsy. Vigilant monitoring and possible adjustments in drug dosage may be warranted in this patient population.