The main idiosyncratic ...

The main idiosyncratic reactions to antiepileptic drugs are: aplastic anemia, Stevens-Johnson syndrome, atopic dermatitis, serum sickness, volchanochnopodobny syndrome, liver failure, pancreatitis, agranulocytosis. Dose-related side effects of anticonvulsants also have important clinical implications. Many antiepileptic drugs, even at therapeutic concentrations, can cause depression of the central nervous system. Cognitive dysfunction is often observed in children receiving phenobarbital. Phenytoin and carbamazepine may cause dysfunction of stem and cerebellum, accompanied by ataxia, dysarthria, nystagmus, sometimes diplopia. Tremor may be dose-related stigmatizing effect of valproate. Paradoxical psychomotor agitation may have children who take benzodiazepines or barbiturates. Risk of side effects associated with drug interactions of anticonvulsants, primarily determined by their effect on the liver enzyme system. Inducers of enzymes are carbamazepine, phenytoin, primidone, phenobarbital. Valproate are potent inhibitors of enzymes (cytochrome P450 2 D6). In the past few years, describes the interactions associated with selective inhibition of metabolism of carbamazepine to its active epoxide metabolite. This interaction may have significant clinical implications, since there is considerable evidence that the epoxide can affect not only the effectiveness of carbamazepine, but its toxic effects. Plasma concentrations of the metabolite of carbamazepine under the influence of valproate may increase four-fold and, consequently, increasing the associated toxicity. These interactions may be unrecognized, as the monitoring of epoxide is usually not carried out. From the standpoint of safety of combination therapy with carbamazepine and valproate is undesirable. The combination of valproate to antipsychotics in the treatment of patients with bipolar disorder may increase the blood concentration of active fractions, and hence the clinical effectiveness of antipsychotics - clozapine, risperidone. Source: http://rusmg.ru

Modern Strategy and Tactics of treatment of patients with epilepsy teens and adolescents with comorbid mental disorders

EL Maksutov, EV Zheleznova, LV Sokolov Institute of Psychiatry, Ministry of Health, Moscow © GlaxoSmithKleine 2003 Age pathomorphosis clinics and course of epilepsy, as is well known, largely depends on the formation of individual structures of the developing brain and the degree of maturation of the motor and mental functions. Along with the evolutive dynamics of the actual epileptic phenomena, most notably at the stage of maturity in the adolescent age, undergo various transformations accompanying mental disabilities, starting with certain disorders of cognitive functions to more pronounced signs psihicheskigo dysontogenesis, including mental underdevelopment.