Epilepsy Unit, Neurology Department, Vall d´Hebron Hospital, Barcelona, Spain.
Neurology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
Acta Neurol Scand. 2019 Jul;140(1):48-55. doi: 10.1111/ane.13099. Epub 2019 May 9.
Aggressive behavior is commonly associated with epilepsy and can be influenced by the antiepileptic drugs (AEDs) taken. Sodium channel blockers, specifically the carboxamides derivatives such as carbamazepine and oxcarbazepine, are some of the AEDs considered to have a favorable psychiatric effect profile.
We aimed to assess whether the carboxamide analogue eslicarbazepine acetate (ESL) has any effect on the levels of anger in patients with epilepsy.
We prospectively recruited adult patients with epilepsy on treatment with ≦2 active AEDs, who required AED addition or substitution, excluding patients with active psychiatric disorders. All patients completed anger level (STAXI-2), depression-anxiety (HADS), and quality of life (QOLIE-10) assessments, and were evaluated at baseline and within 3-6 months after treatment initiation.
Of 78 patients receiving ESL, as add-on therapy or in substitution of a previous AED, were recruited into the ESL group, with an average age of 48 years and 54% men. We used a control group of 58 patients receiving AEDs other than carboxamides.
Patients overall showed improvements in anger levels, mood, and quality of life during the follow-up. A history of psychiatric disorders was a limiting factor to improve anger levels. As compared to controls, anger levels improved in ESL patients independently from seizure control. Therefore, ESL seems to exert a favorable influence on the anger levels of otherwise healthy patients with epilepsy, including those unresponsive to seizure control. The potential ESL anti-aggressive effect should be studied in patients with epilepsy and active psychiatric disorders.
攻击性行为通常与癫痫有关，并且可能受到所服用的抗癫痫药物（AEDs）的影响。钠通道阻滞剂，特别是卡马西平（carbamazepine）和奥卡西平（oxcarbazepine）等羧酰胺衍生物，是一些被认为具有良好精神科效应特征的 AEDs。
我们旨在评估羧酰胺类似物依佐加滨（eslicarbazepine acetate，ESL）是否对癫痫患者的愤怒水平有任何影响。
我们前瞻性招募了正在接受≤2 种活性 AED 治疗、需要添加或替代 AED 的成年癫痫患者，排除了有活动性精神障碍的患者。所有患者在基线和治疗开始后 3-6 个月内完成愤怒水平（STAXI-2）、抑郁焦虑（HADS）和生活质量（QOLIE-10）评估。
在接受 ESL 添加治疗或替代先前 AED 的 78 例患者中，有 54%为男性，平均年龄为 48 岁，纳入 ESL 组。我们使用了接受非羧酰胺类 AED 的 58 例患者作为对照组。
患者在随访期间整体上显示出愤怒水平、情绪和生活质量的改善。精神病史是改善愤怒水平的一个限制因素。与对照组相比，ESL 患者的愤怒水平在控制癫痫发作的情况下得到改善。因此，ESL 似乎对其他健康的癫痫患者的愤怒水平产生有利影响，包括那些对癫痫发作控制无反应的患者。应该在患有癫痫和活动性精神障碍的患者中研究 ESL 的潜在抗攻击作用。
