Treatment modifications of antiseizure medications in children due to adverse drug reactions: The parents' perspective.

BACKGROUND

Adverse drug reactions (ADRs) occur frequently in the treatment with antiseizure medication (ASM). We investigated the influence of experienced ADRs on desired or actual treatment modifications in paediatric patients from the parents' perspective.

METHODS

We interviewed 104 parents of children with an epilepsy diagnosis in routine paediatric care at a German university hospital. The questionnaire comprised questions about current and previous experiences with ASM regarding ADRs leading to desired or actual treatment modifications.

RESULTS

Of 94 parents of children with current ASM, 11/94 (12 %) desired treatment modifications because of ADRs. Of 66 parents of children with previous ASM treatment, 51/66 (77 %) reported a total of 72 actual ADR-related modifications in the past. The most frequently mentioned ADRs leading to desired or actual treatment modifications were fatigue (current: 7/94 [7 %]; previous: 23/72 [32 %]), behavioural changes (current: 6/94 [6 %]; previous: 28/72 [39 %]), and negative changes in cognitive processes (current: 3/94 [3 %]; previous: 12/72 [17 %]). In total, parents attributed ADR-related desired or actual treatment modifications to 14 different ASMs. Behavioural changes leading to desired or actual modifications were mentioned for 10/14 (71 %) ASMs, fatigue for 9/14 (64 %) ASMs, and negative changes in cognitive processes for 8/14 (57 %) ASMs.

CONCLUSION

One-in-ten parents desired to modify current ASM treatment due to ADRs, and almost two thirds reported actual ADR-related modifications of previous ASMs. As the same ADRs were reported for different ASMs, those ADRs may not be preventable through ASM variation. Thus, coping strategies are needed, particularly for the occurrence of common neurological and psychiatric ADRs.