University Hospital Maastricht, The Netherlands.
Res Dev Disabil. 2011 Nov-Dec;32(6):2660-8. doi: 10.1016/j.ridd.2011.06.007. Epub 2011 Jul 12.
A large number of patients with epilepsy and intellectual disability take medication, amongst which antiepileptic and psychotropic drugs, often simultaneously. Certain antiepileptic drugs have mood-stabilizing properties, e.g. carbamazepine, valproic acid and lamotrigine. The aim of this study was to investigate whether the use of these mood-stabilizers is associated with a different use of psychotropic drugs in a population of institutionalized epilepsy patients with intellectual disability. We performed a retrospective, cohort study of adults with intellectual disability and epilepsy at the long-stay department of an epilepsy centre in The Netherlands. 246 residents were included. In patients using lamotrigine we found a statistically significant lower use of antidepressants. We also found significant less prescriptions of anxiolytics in patients using AEDs with mood-stabilizing properties (carbamazepine, valproic acid and lamotrigine). When considering the effect of gender, we found that male patients took significantly more antipsychotics. Most important, we found an inverse relation between the drug load of carbamazepine and/or valproic acid and/or lamotrigine and the use of psychotropic drugs. In a population of institutionalized epilepsy patients with intellectual disability, higher drug loads of mood-stabilizing antiepileptic drugs correspond with less use of psychotropic drugs.
大量患有癫痫和智力障碍的患者需要服药，其中包括抗癫痫药和精神药物，且经常同时服用。某些抗癫痫药物具有稳定情绪的特性，例如卡马西平、丙戊酸和拉莫三嗪。本研究旨在调查在患有智力障碍的住院癫痫患者人群中，使用这些情绪稳定剂是否与精神药物的不同使用有关。我们对荷兰一家癫痫中心的长期护理部门的智力障碍和癫痫成人患者进行了回顾性队列研究。共纳入 246 名患者。在使用拉莫三嗪的患者中，我们发现抗抑郁药的使用明显减少。我们还发现，在使用具有稳定情绪特性的抗癫痫药物（卡马西平、丙戊酸和拉莫三嗪）的患者中，使用抗焦虑药物的处方明显减少。当考虑到性别的影响时，我们发现男性患者服用的抗精神病药物明显更多。最重要的是，我们发现卡马西平、丙戊酸和/或拉莫三嗪的药物负荷与精神药物的使用呈反比关系。在患有智力障碍的住院癫痫患者人群中，具有稳定情绪特性的抗癫痫药物的药物负荷越高，精神药物的使用就越少。
