Institute of Pharmacy and Biomedical Science, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
Expert Rev Clin Pharmacol. 2012 May;5(3):281-92. doi: 10.1586/ecp.12.10.
Polytherapy antiepileptic drug (AED) regimens are prevalent in the treatment of epilepsy and the potential for AEDs to interact results in many challenges. Understanding the underlying mechanism of an interaction, along with the magnitude and its time course of presentation can allow a graded and informed therapeutic adjustment so as to minimize the adverse consequences (breakthrough seizures, increased adverse effects) of the interaction. The purpose of the present review is to address the importance of characterizing interactions among AEDs and to emphasize how preclinical studies, both in vitro and in animal models, can help inform the design of clinical studies and the characterization of potential interactions in patients with epilepsy. In addition, we review and discuss methodological issues of how case studies, population pharmacokinetic data and data from therapeutic drug-monitoring databases can provide invaluable signals regarding potential interactions that have yet to be investigated in formal clinical trials.
多药抗癫痫药物（AED）治疗方案在癫痫治疗中很常见，AED 相互作用的可能性会带来许多挑战。了解相互作用的潜在机制，以及其表现的幅度和时程，可以进行分级和知情的治疗调整，从而将相互作用的不良后果（突破性发作、增加的不良反应）降至最低。本综述的目的是强调描述 AED 相互作用的重要性，并强调临床前研究（包括体外和动物模型研究）如何帮助为临床研究的设计和癫痫患者潜在相互作用的特征提供信息。此外，我们还回顾和讨论了病例研究、群体药代动力学数据以及治疗药物监测数据库数据如何提供有价值的信号，这些信号涉及尚未在正式临床试验中研究的潜在相互作用的方法学问题。
