Cross-sensitivity of psychiatric and behavioral side effects with antiepileptic drug use
Cross-sensitivity of psychiatric and behavioral side effects with antiepileptic drug use
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DOI：
10.1016/j.seizure.2018.09.014
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发表时间：
2018-11-01
影响因子：
3
通讯作者：
Detyniecki, Kamil
中科院分区：
文献类型：
--
作者：
Chen, Baibing;Choi, Hyunmi;Detyniecki, Kamil
目的：为了确定不能忍受的精神和行为的副作用（IPBSE）之间的交叉敏感性常用的抗癫痫药物（AEDs）在成人patients.Methods：IPBSE被定义为精神或行为的副作用归因于AED的使用，导致剂量减少或停止的AED。计算交叉敏感性，并将其定义为IPBSE与另一种AED发生IPBSE的可能性。我们的样本包括2312名成人患者，处方2种或更多种AED。结果：在2312例患者中，20.2%的患者服用了至少2种AED，IPBSE（S）归因于至少一种AED; 3.5%的患者IPBSE归因于两种或两种以上AED。抑郁症和精神病的治疗史被认为是IPBSE发生的重要预测因素（p < 0.001），并且在所有AED特异性分析中得到了控制。在LEV和ZNS之间观察到交叉敏感性（p < 0.001）。从IPBSE到LEV的几率显著增加（41.5%; OR = 2.7; p < 0.001）或ZNS（22.1%; OR = 3.5; p < 0.001），如果患者对另一种AED有IPBSE，与对其他AED无IPBSE相比结论：有精神病史和抑郁史者，抗癫痫药物引起IPBSE的危险性增加。如果患者在使用另一种AED时发生IPBSE，则使用LEV或ZNS的患者发生IPBSE的概率增加。我们的研究结果可能是临床上有用的预测IPBSE与某些AED。
Purpose: To determine rates of cross-sensitivity of intolerable psychiatric and behavioral side effects (IPBSEs) among commonly used antiepileptic drugs (AEDs) in adult patients with epilepsy.Methods: IPBSE was defined as a psychiatric or behavioral side effect attributed to AED use that led to a decrease in dose or cessation of an AED. Cross-sensitivity was calculated and was defined as the likelihood of developing IPBSE to a specific AED given IPBSE to another AED. Our sample consisted of 2312 adult patients that were prescribed 2 or more AEDs. Non-AED confounders and were controlled for in all analyses.Results: Among the 2312 patients, 20.2% of patients who had taken at least 2 AEDs had IPBSE(s) attributed to at least one AED; 3.5% had IPBSE to two or more AEDs. History of treated depression and psychosis were found to be significant predictors (p < 0.001) of developing IPBSE and were controlled for in all AED-specific analyses. Cross-sensitivity was seen between LEV and ZNS (p < 0.001). There was a significant increase in odds of experiencing IPBSE to LEV (41.5%; OR = 2.7; p < 0.001) or ZNS (22.1%; OR = 3.5; p < 0.001) given a patient had IPBSE to another AED compared to having no IPBSE to other AEDs (20.5% and 7.5%, respectively).Conclusion: History of depression and psychosis increased risk of developing IPBSE to AEDs. The probability of experiencing IPBSE increased for a patient taking LEV or ZNS if the patient experienced IPBSE to another AED. Our results may be clinically useful for predicting IPBSE associated with certain AEDs.