Truly "rational" polytherapy: Maximizing efficacy and minimizing drug interactions, drug load, and adverse effects

Current Neuropharmacology

Volumn 7, Issue 2, 2009, Pages 96-105

  St Louis, Erik K ^a  

^a MAYO CLINIC   (United States)

Author keywords

Antiepileptic drugs; Drug interactions; Drug load; Epilepsy; Polytherapy

Indexed keywords

ANTICONVULSIVE AGENT; CARBAMAZEPINE; CLONAZEPAM; CYTOCHROME P450; ETHOSUXIMIDE; ETIRACETAM; FELBAMATE; GABAPENTIN; HARKOSERIDE; LAMOTRIGINE; OXCARBAZEPINE; PHENOBARBITAL; PHENYTOIN; PREGABALIN; PRIMIDONE; RUFINAMIDE; TIAGABINE; TOPIRAMATE; VALPROATE SEMISODIUM; VALPROIC ACID; VIGABATRIN; ZONISAMIDE;

CLINICAL PRACTICE; CLINICAL TRIAL; DRUG BLOOD LEVEL; DRUG EFFICACY; DRUG INDICATION; DRUG POTENTIATION; DRUG TOLERABILITY; ENZYME INDUCTION; ENZYME INHIBITION; EPILEPSY; FOOD AND DRUG ADMINISTRATION; HUMAN; MEDICAL DECISION MAKING; MONOTHERAPY; NEUROLOGIC DISEASE; NEUROSURGERY; PATIENT SELECTION; POLYPHARMACY; PRACTICE GUIDELINE; RASH; REVIEW; RISK ASSESSMENT; SIDE EFFECT; SUDDEN DEATH; VAGUS NERVE STIMULATION;

EID: 70349662030     PISSN: 1570159X     EISSN: None     Source Type: Journal    
DOI: 10.2174/157015909788848929     Document Type: Review

References (81)

1. Arroyo, S., De La Morena, A. (2001) Life-threatening adverse effects of antiepileptic drugs. Epilepsy Res., 47, 155-174.
2. Baulac, M. (2003) Rational conversion from antiepileptic polytherapy to monotherapy. Epileptic Disord., 5, 125-132.
3. Bien, C.G., Kurthen, M., Baron, K., Lux, S., Helmstaedter, C., Schramm, J., Eiger, CE. (2001) Long-term seizure outcome and antiepileptic drug treatment in surgically treated temporal lobe epilepsy patients: a controlled study. Epilepsia, 42, 1416-1421.
4. Boon, P., D'Have, M., Van Walleghem, P., Michielsen, G., Vonch, K., Caemaert, J., DeReuck, J. (2002) Direct medical costs of refractory epilepsy incurred by three different treatment modalities: a prospective assessment. Epilepsia, 43, 96-102.
5. Bourgeois, B.F. (1986) Antiepileptic drug combinations and experimental background: the case of phenobarbital and phenytoin. Naunyn Schmiedebergs Arch. Pharmacol., 333, 406-411.
6. Bourgeois, B.F. (1998) Problems of combination drug therapy in children. Epilepsia, 29(Suppl 3), S20-S24.
7. Brodie, M.J., Yuen, A.W. (1997) Lamotrigine substitution study: evidence for synergism with sodium valproate? 105 Study Group. Epilepsy Res., 26(3), 423-432.
8. Chen, C.C., Chin, P.C., Chen, M.T. (2007) Reinvestigation and reduction of polytherapy in children with chronic seizures. J. Child Neurol. 22(1). 15-20.
9. Chez, M.G., Bourgeois, B.P., Pippenger, G.E., Knowles, W.D. (1994) Pharmacodynamic interactions between pbenytoin and valproate: individual and combined antiepileptic and neuratoxic actions in mice. Clin. Neuropharmacol., 17, 32-37.
10. Cohen, B., Showstack, N., Myerson, A. (1940) The synergism of phenobarbital and Dilantin sodium and other drugs. JAMA, 114, 480-484.
11. Cramer, J.A., Fisher, R., Ben-Menachem, E., French, J., Mattson, R.H. (1999) New antiepileptic drugs: comparison of key clinical trials. Epilepsia, 40, 590-600.
12. Crawford, P., Chadwick, D. (1986), A comparative study of progabide, valproate, and placebo as add-on therapy in patients with refractory epilepsy. J. Neurol. Neurosurg. Psychiatr., 49, 1251-1257.
13. Crawford, P. (2002) Epilepsy and pregnancy. Seizure 11(Suppl A), 212-219.
14. Czuczwar, S.J., Borowicz, K.K. (2002) Polytherapy in epilepsy: the experimental evidence. Epilepsy Res., 52, 15-23
15. Dean, J.C., Penry, J.K. (1988) Carbamazapine/valproate therapy in 100 patients with partial seizures failing carbamazepine monotherapy: long term follow-up. Epilepsia, 29, 687.
16. Deckers, C.L.P., Hekster, Y.A., Keyser, A., Meinardi, H., Renier, W.O. (1997) Reappraisal of polytherapy in epilepsy; a critical review of drug load and adverse effects. Epilepsia, 38, 570-575.
17. Deckers, C.L.P., Czuczwar, S.J., Hekster, Y.A., Keyser, A., Kubova, H., Meinardi, H., Patsalus, P.N., Reiner, W.O., Van Rijn, C.M. (2000) Selection of antiepileptic drug polytherapy based on mechanisms of action: the evidence reviewed. Epilepsia, 41, 1364-1374.
18. Deckers, C.L.P., Hekster, Y.A., Keyser, A., van Lier, H.J., Meinardi, H., Renier, W.O. (2001) Monotherapy vs. Polytherapy for epilepsy: a multicenter double-blind randomized study. Epilepsia, 42, 1387-1394.
19. Deckers, C.L.P. (2002) The place of combination therapy in the early treatment of epilepsy: CNS Drugs, 16, 155-163.
20. Deckers, C.L.P. (2002) Over treatment in adults with epilepsy. Epilepsy Res., 52, 43-52.
21. Deckers, C.L.P., Genton, P., Sills, G.J., Schmidt, D. (2003) Current limitations of antiepileptic drug therapy: a conference review. Epilepsy Res. 53, 1-17.
22. Díaz, R.A., Sancho, J., Serratosa, J. (2008) Antiepileptic drug interactions. Neurologist, 14(6 Suppl 1), S55-65.
23. El-Hajj Fuleihan, G., Dib, L., Yamout, B., Sawaya, R., Mikati, M.A. (2008) Predictors of bone density in ambulatory patients on antiepileptic drugs. Bone, 43(1), 149-155.
24. French, J.A., Kanner, A.M., Bautista, J., Abou-Khalil, B, Browne, T., Harden, C.L., Theodore, W.H., Bazil, C., Stern, J., Schachter, S.C., Bergen, D., Hirtz, D., Mantouris, G.D., Nespeca, M., Gidal, B., Marks, W.J. Jr., Turk, W.R., Fischer, J.H., Bourgeois, B., Willner, A., Faught, R.E. Jr., Sachdeo, R.C., Beydoun, A. (2004) Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology; Quality Standards Subcommittee of the American Academy of Neurology; American Epilepsy Society. Efficacy and tolerability of the new antiepileptic drugs II: treatment of refractory epilepsy: report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology, 62, 1261-1273.
25. Gilliam, F.G., Fessler, A.J., Baker, G., Vahle, V., Carter, J., Attarian, H. (2004) Systematic screening allows reduction of adverse antiepileptic drug effects: a randomized trial. Neurology 62, 23-27.
26. Hakkarainen, H. (1980) Carbamazepine vs. diphenylhydrantoin vs. their combination in adult epilepsy. Neurology, 30, 354.
27. Harms, S.L., Eberly, L.E., Garrard, J.M., Hardie, N.A., Bland, P.C., Leppik, I.E. (2005) Prevalence of appropriate and problematic antiepileptic combination therapy in older people in the nursing home. JAGS, 53, 1023-1028.
28. Hill, M.W., Reddy, P.A., Covey, D., Rothman, S.M. (1998) Inhibition of voltage-dependent sodium channels by the anticonvulsant γ-aminobutyric acid type A receptor modulator, 3-benzyl-3-ethyl-2-piperidinone. J. Pharmacol. Exper. Ther., 285, 1303-1309.
29. Holmes, G.L. (2002) Over treatment in children with epilepsy. Epilepsy Res., 52, 35-42.
30. Jallon, P. (1997) The problem of intractability: the continuing need for new medical therapies in epilepsy. Epilepsia, 38(Suppl 9), S37-S42.
31. Kanner, A.M., Frey, M. (1999) Do valproic acid and lamotrigine have a synergistic effect? Epilepsia, 40(Suppl 2), 284. Abstract.
32. Kuzniecky, R., Rubin, Z.K., Faught, E., Morawetz, R. (1992) Antiepileptic drug treatment after temporal lobe epilepsy surgery: a randomized study comparing carbamazepine and polytherapy. Epilepsia, 33, 908-912.
33. Krumholz, A (1999) Nonepileptic seizures: diagnosis and management. Neurology, 53(5 Suppl 2), S76-83.
34. Kwan, P., Brodie, M.J. (2000) Early identification of refractory epilepsy. N. Engl. J. Med., 342, 314-319.
35. Kwan, P., Brodie, M.J. (2001) Effectiveness of first antiepileptic drug. Epilepsia 42, 1255-1260.
36. Kwan, P., Brodie, M.J. (2004) Drug treatment of epilepsy: when does it fail and how to optimize its use? CNS Spectr., 9, 110-119.
37. Kwan, P., Sander, J.W. (2004) The natural history of epilepsy: an epidemiological view. J. Neurol. Neurosurg. Psychiatry, 75, 1376-1381.
38. Labar, D.R., (2002) Antiepileptic drug use during the first 12 months of vagus nerve stimulation therapy: a registry study. Neurology, 59(6 Suppl 4), S38-S43.
39. Lammers, M.W., Hekster, Y.A., Keyser, A., Meinardi, H., Renier, W.O., van Lier, H. (1995) Monotherapy or polytherapy for epilepsy revisited: a quantitative assessment. Epilepsia, 36, 440-446.
40. Leppik, I.E. (2000) Monotherapy and polytherapy. Neurology, 55(11 Suppl 3), S25-S29.
41. Lorenzo, N.Y., Bromfield, E.B., Theodore, W.H. (1988) Phenytoin and carbamazepine: combination versus single-drug therapy for intractable partial seizures. Ann. Neurol., 24, 136.
42. Lukyanetz, E.A., Shkryl, V.M., Kostyuk, P.G. (2002) Selective blockade of N-type calcium channels by levetiracetam. Epilepsia, 43, 9-18.
43. Lynch, B.A., Lambeng, N., Nocka, K., Kensel-Hammes, P., Bajjalieh, S.M., Matagne, A., Fuks, B. (2004) The synaptic vesicle protein SV2A is the binding site for the antiepileptic drug levetiracetam. Proc. Natl. Acad. Sci. USA, 101(26), 9861-9866.
44. Maher, J., McLachlan, R.S. (1998) Antiepileptic drug treatment following temporal lobectomy. Neurology, 51, 305-307.
45. Mamiya, K., Yukawa, E., Matsumoto, T., Aita, C., Goto, S. (2002) Synergistic effect of valproate coadministration and hypoalbuminemia on the serum-free phenytoin concentration in patients with severe motor and intellectual disabilities. Clin. Neuropharmacol., 25, 230-233
46. Marson, A., Beghi, E., Berg, A., Chadwic, k D., Tonini. C. (1996) The Cochrane collaboration: systematic reviews and their relevance to epilepsy. The Cochrane Epilepsy Network. Epilepsia, 37, 917-921
47. Matagne, A.C., Baltes, E., Coupez, R., et al. (2001) Levetiracetam enhances markedly the seizure suppression of other antiepileptic drugs in audiogenic susceptible mice. Epilepsia, 42, 82, Abstract.
48. Mattson, R.M., Cramer, J.A., Collins, J.F., Smith, D.B., Delgado-Escueta. A.V., Browne, T.R., Williamson, P.D., Treiman, D.M., McNamara, J.O., McCutchen, C.B. (1985) Comparison of phenobarbital, phenytoin, carbamazepine, and primidone in partial and secondary generalized tonic-clonic seizures. N. Engl. J. Med., 313, 145-151.
49. Mattson, R.M., Cramer, J.A. (1993) The choice of antiepileptic drugs in focal epilepsy. In: Wyllie E, editor. The Treatment of Epilepsy: Principles and Practice, 1st ed. Philadelphia: Lea and Feibiger, 817-823.
50. Meador, K.J. (1998) Cognitive and behavioral assessments in AED trials. In: Ed. French J, Leppik I, Dichter MA, editors. Antiepileptic Drug Development, Advances in Neurology, Volume 76; Philadelphia: Lippincott-Raven, 231-238.
51. Meador, K.J., Loring, D.W., Moore, E.E., Thompsom, W.O., Nichols, M.E., Oberzan, R.E., Durkin, M.W., Gallagher, B.B., King, D.W. (1995) Comparative cognitive effects of phenobarbital, phenytoin, and valproate in healthy adults. Neurology, 45, 1494-1499.
52. Meador, K.J. (2002) Cognitive outcomes and predictive factors in epilepsy. Neurology, 58, S21-S26.
53. Messenheimer, J., Mullens, E., Giorgi, L., Young, F. (1998) Safety review of adult clinical trial experience with lamotrigine. Drug Saf., 18, 281-296.
54. Murri, L., Iudice, A. (1995) Vigabatrin as first add-on treatment in carbamazepine-resistant patients. Acta Neurol. Scand., 162(Suppl), 10-12.
55. Nadkarni, S., LaJoie, J., Devinsky, O. (2005) Current treatment of epilepsy. Neurology, 64(Suppl 3), S2-S11.
56. Naritoku, D.K., Hulihan, J.F., Schwarzman, L.K., Kamm, M., Olson, W.H. (2005) Effect of cotherapy reduction on tolerability of epilepsy add-on therapy: a randomized controlled trial. Ann. Pharmacother., 39, 418-423.
57. Oguni, M., Osawa, M. (2004) Epilepsy and pregnancy. Epilepsia, 45(Suppl8), 37-41.
58. Patsalos, P.N., Froscher, W., Pisani, F., van Rijn, C.M. (2002) The impotance of drug interactions in therapy. Epilepsia, 43, 365-385.
59. Pennell, P.B. (2003) Antiepileptic drug pharmacokinetics during pregnancy and lactation. Neurology, 61(6 Suppl 2), S35-S42.
60. Perucca E. (1995) Pharmacological principles as a basis for poly-therapy. Acta Neurol. Scand. Suppl., 162, 31-34.
61. Privitera, M.D., Brodie, M.J., Mattson, R-H., Chadwick, D.W., Neto, W., Wand, S., EPMN 105 Study Group. (2003) Topiramate, carbamazepine, and valproate monotherapy: double-blind comparison in newly diagnosed epilepsy. Acta Neurol. Scan., 107, 165-175.
62. Rahmann, A., Stodieck, S., Husstedt, L.W., Evers, S. (2002) Pre-attentive cognitive processing in epilepsy: a pilot study on the impact of epilepsy type and anti-epileptic treatment. Eur. Neurol., 48, 146-152.
63. Reife, R., Pledger, G., Wu, S.C. (2000) Topiramate as add-on therapy: pooled analysis of randomized controlled trials in adults. Epilepsia, 41(Suppl 1), S66-S71.
64. Roks, G., Deckers, C.L.P., Meinardi, H Dirksen, R., Van Egmond, J., van Rijn, C.M. (1999) Effects of polytherapy compared with monotherapy in antiepileptic drugs: an animal. JPET, 288, 472-477.
65. Schiller, Y., Cascino, G.D., So, E.L., Marsh, W.R. (2000) Discontinuation of antiepileptic drugs after successful epilepsy surgery Neurology, 54, 346-349.
66. Schmidt, D. (1996) Modern management of epilepsy; rational polytherapy. Ball. Clin. Neurol., 1996, 5, 757-763.
67. Schmidt, D., Elger, C., Holmes, G.L. (2002) Pharmacological over treatment in epilepsy: mechanisms and management. Epilepsy Res., 5, 3-14.
68. Sillanpää, M., Schmidt. D. (2006) Natural history of treated childhood onset epilepsy: prospective long term population-based study. Brain, 129, 617-624.
69. Stephen, L.J., Brodie. M.J. (2002) Seizure-freedom with more than one antiepileptic drug. Seizure 11, 349-351.
70. St. Louis. E.K., McEvoy, S., Shi, Q.C., Rizzo, M. (2005) Useful Field of View Impairment in Partial Epilepsy. In: Proceedings of the 3rd International Driving Symposium on Human Factors in Driver Assessment, Training, and Vehicle Design. Iowa City, Iowa: University of Iowa Press.
71. St Louis, E.K., Chang, S., Granner, M.A., Howard, M., Kawasaki, H. (2007) Reduction of antiepileptic drug treatment following epilepsy surgery. Epilepsia, 48(S6), 150.
72. St Louis, E.K., Gidal, B.E., Henry, T.R., Kaydanova, Y., Krumholz, A,. McCabe, P.H., Montouris, G.D., Rosenfeld, W.E., Smith, B.J., Stem, J.M., Waterhouse, E.J., Garpett, W.R., Bramley, T. (2007) Conversions between monotherapies in epilepsy: expert consensus. Epilepsy Behav., 11, 222-234.
73. Tanganelli, P., Regesta, G. (1996) Vigabatrin vs. carbamazepine in newly diagnosed focal epilepsy: a randomized response conditional cross-over study. Epilepsy Res., 25, 257-262.
74. Temkin, O. (1994) The Falling Sickness: A History of Epilepsy from the Greeks to the Beginnings of Modern Neurolog, 2nd ed. Baltimore: Johns Hopkins Press.
75. Thomas, S., Koshy, S., Sudhakaran, N., Nair, C.R., Sarma, S.P. (2005) Frequent seizures and polytherapy can impair quality of life in persons with epilepsy. Neurol. India, 53, 46-50.
76. Thomas, SV., Ajaykumar, B., Sindhu, K., Nair, M.K., George, B., Sarma, P.S. (2008) Motor and mental development of infants exposed to antiepileptic drugs in utero. Epilepsy Behav., 13(1), 229-236.
77. Trimble, M.R., Thompson, P.J. (1983) Anticonvulsant drugs, cognitive function, and behavior. Epilepsia, 24(Suppl 1), S55-S63.
78. Vining, E.P. (1987) Cognitive dysfunction associated with antiepileptic drug therapy. Epilepsia, 28(Suppl 2), S18-S22.
79. Valker, J.F. Koon, P. (1988) Carbamazepine versus valproate versus combined therapy for refractory partial seizures with secondary generalization. Epilepsia, 29, 693.
80. Wieser, H.G., Hane, A. (2003) Antiepileptic drug treatment before and after selective amygdalohippocampectomy. Epilepsy Res., 56, 211-223.
81. WHO Collaborating Centre for Drug Statistics Methodology. ATC/DDD Index 2009. Accessed on 4/28/09, 1730 hours, from: http//www.whocc.no/atcddd/.