Differences in levetiracetam and perampanel treatment-related irritability in patients with epilepsy
Differences in levetiracetam and perampanel treatment-related irritability in patients with epilepsy
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DOI：
10.1016/j.yebeh.2020.107644
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发表时间：
2021-03-04
影响因子：
2.6
通讯作者：
Tohyama, Jun
中科院分区：
文献类型：
--
作者：
Hasegawa, Naoya;Tohyama, Jun
目的：本研究评价了接受左乙拉西坦（LEV）和perampanel（PER）治疗的癫痫患者是否出现易怒副作用。该研究还研究了患者特征与易怒之间的关系，当它作为副作用发生时。研究方法：我们回顾性研究了98例癫痫患者的医疗记录，这些患者在日本Nishiniigata Chuo国立医院癫痫中心精神科接受LEV和PER治疗。我们进行了多元回归分析的存在/不存在的易怒由于左心室或PER作为因变量和患者的临床特征作为自变量。结果：98例患者中，LEV和PER分别有7例和17例引起过敏。在相同的患者中没有发生LEV-PER相关的易激惹。Logistic多元回归分析显示，EEG结果颞叶局灶性癫痫放电与LEV引起的易激惹发生率增加显著相关。LEV相关的应激性随着LEV剂量的增加而显著降低。另一项Logistic多元回归分析显示，精神科合并症的易怒和EEG结果的非颞叶局灶性癫痫放电与易怒的发生率增加，由于PER显着相关。结论：LEV和PER在不同的患者组中引起易怒。此外，作为副作用的易怒只存在于低剂量的LEV，但PER往往会导致易怒，即使在高剂量。(c)2020作者（S）爱思唯尔公司出版这是一个在CC BY-NC-ND许可证下的开放获取文章（http：//creativecommons.org/licenses/by-nc-nd/4.0/）。
Purpose: The present study evaluated whether patients with epilepsy who received both levetiracetam (LEV) and perampanel (PER) therapy showed side effects of irritability. The study also examined the relationship between patient characteristics and irritability when it occurred as a side effect. Methods: We retrospectively examined medical records of 98 patients with epilepsy who were treated with both LEV and PER at the Department of Psychiatry in the Epilepsy Center of Nishiniigata Chuo National Hospital in Japan. We performed multiple regression analyses with the presence/absence of irritability due to LEV or PER as the dependent variables and clinical characteristics of the patients as independent variables. Results: LEV and PER caused irritability in 7 and 17 of 98 patients, respectively. LEV-and PER-related irritability did not occur in the same patients. A logistic multiple regression analysis revealed that EEG findings of temporal focal epileptic discharge were significantly associated with increased incidence of irritability due to LEV. LEV-related irritability decreased significantly with higher dosages of LEV. Another logistic multiple regression analysis revealed that a psychiatric comorbidity of irritability and EEG findings of nontemporal focal epileptic discharge were significantly associated with increased incidence of irritability due to PER. Conclusions: LEV and PER cause irritability in different patient groups. Additionally, irritability as a side effect was present only at low dosages of LEV, but PER tended to cause irritability even at high dosages. (c) 2020 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).