Neath Port Talbot CLDT, Morriston, Swansea, UK.
School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Republic of Ireland.
Expert Opin Pharmacother. 2020 Feb;21(2):173-181. doi: 10.1080/14656566.2019.1695780. Epub 2019 Nov 30.
: This clinical guidance looks at the specific concerns of delivery of medical treatment for people with epilepsy and intellectual disability (ID). People with ID have not been included in licensing drug trials of AEDs. However, this population has an over-representation of seizure comorbidity, treatment resistance, and polypharmacy while also being vulnerable to not having their views considered.: This review summarizes the current most robust evidence available for the use of licensed AEDs in people with epilepsy and ID. The article provides practical evidence-based clinical information to help prescribers choose the most appropriate AED from the drugs discussed. The article highlights other important individualized factors to consider before initiating or changing antiepileptic medication.: A 'traffic light' coding system is applied to commonly used AEDs based on the level of evidence and expert clinical experience. Managing epilepsy in the ID population requires specialist care. Treatment plans need to be holistic and tailored to accommodate an individual's comorbidities, concurrent medications, general health, social and environmental status. There is a need for large quality trial data to assess the most suitable AEDs on seizure control and quality of life in this population with complex needs.
: 本临床指南着眼于为癫痫和智力障碍(ID)患者提供医疗服务的具体问题。在抗癫痫药物(AED)的药物试验中,并未纳入 ID 人群。然而,该人群癫痫共病、治疗抵抗和多药治疗的比例过高,同时也容易出现其观点未被考虑的情况。: 本文总结了目前可用于癫痫合并 ID 患者的已获许可 AED 的最可靠证据。本文提供了实用的循证临床信息,以帮助处方者从讨论的药物中选择最合适的 AED。本文还强调了在开始或改变抗癫痫药物治疗之前,需要考虑其他重要的个体化因素。: 本文根据证据水平和专家临床经验,对常用 AED 应用“红绿灯”编码系统进行分类。在 ID 人群中管理癫痫需要专业护理。治疗计划需要全面,并针对个体的共病、同时服用的药物、一般健康状况、社会和环境状况进行调整。需要有高质量的临床试验数据来评估最适合该人群的 AED,以控制癫痫发作和提高生活质量,因为该人群的需求复杂。