Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery, UNAM, México City, Mexico.
Seizure. 2012 Oct;21(8):588-94. doi: 10.1016/j.seizure.2012.06.003. Epub 2012 Jul 7.
After reviewing the negative effects of antiepileptic drugs (AEDs) on general health and quality of life, the Commission on Outcome Measurement from the International League Against Epilepsy (ILAE) recommended incorporating reliable and valid tools in clinical essays in order to achieve a more accurate assessment of the subjective adverse effects rate and disease severity when using AEDs.
The aim of this study was to correlate the severity of adverse effects of AEDs, with the presence of anxiety and depression in patients with epilepsy.
The Spanish version of the Liverpool Adverse Events Profile (LAEP) and the hospital anxiety and depression scale (HADS) were applied on 130 consecutive outpatients with epilepsy from the epilepsy clinic at the Mexico's National Institute of Neurology and Neurosurgery. A correlation analysis was carried out to determine if the presence of depression and anxiety was related to the adverse effects of AEDs. The relation between LAEP scores with other epidemiological variables was also assessed.
Our study found a positive correlation between the LAEP and the HADS scores (p < or = 0.01). The most common adverse effects were drowsiness (81.5% [n=106]), difficulty in concentrating (76% [n=99]), and nervousness and/or agitation (75% [n=97]). Female gender, a history of febrile seizures, persistent seizures and polytherapy were associated with a higher toxicity on LAEP. In our study, age at epilepsy onset, duration of epilepsy, type of epilepsy and patients' age were not related to higher LAEP scores.
Adverse effects to AEDs can be related with the presence of psychiatric disorders such as anxiety and depression in patients with epilepsy.
在回顾抗癫痫药物(AEDs)对总体健康和生活质量的负面影响后,国际抗癫痫联盟(ILAE)结局测量委员会建议在临床论文中纳入可靠和有效的工具,以便在使用 AEDs 时更准确地评估主观不良反应率和疾病严重程度。
本研究旨在评估 AEDs 不良反应的严重程度与癫痫患者焦虑和抑郁的关系。
对来自墨西哥国家神经病学与神经外科学研究所癫痫诊所的 130 例连续癫痫门诊患者应用西班牙版利物浦不良反应量表(LAEP)和医院焦虑抑郁量表(HADS)。进行相关性分析以确定抑郁和焦虑的存在与 AEDs 不良反应是否相关。还评估了 LAEP 评分与其他流行病学变量之间的关系。
我们的研究发现 LAEP 与 HADS 评分之间存在正相关(p≤0.01)。最常见的不良反应是嗜睡(81.5%[n=106])、注意力难以集中(76%[n=99])和紧张不安和/或激动(75%[n=97])。女性、热性惊厥史、持续性癫痫发作和多药治疗与 LAEP 毒性较高相关。在我们的研究中,癫痫发作年龄、癫痫持续时间、癫痫类型和患者年龄与较高的 LAEP 评分无关。
AEDs 的不良反应可能与癫痫患者焦虑和抑郁等精神障碍的存在有关。