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Research ArticleOriginal Article
Open Access

Frequency of antiepileptic drugs and response change in pediatric patients receiving 2 or more antiepileptic drugs

Abla M. Albsoul-Younes, Amira T. Masri, Lobna F. Gharaibeh, Amer A. Murtaja and Abdelkarim A. Al-Qudah
Neurosciences Journal August 2020, 25 (4) 269-275; DOI: https://doi.org/10.17712/nsj.2020.4.20190113
Abla M. Albsoul-Younes
From the Department of Biopharmaceutics and Clinical Pharmacy (Albsoul-Younes, Gharaibeh, Murtaja), School of Pharmacy, Department of Pediatrics (Masri, Al-Qudah), School of Medicine, University of Jordan, Amman, Jordan
BSc, PhD
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Amira T. Masri
From the Department of Biopharmaceutics and Clinical Pharmacy (Albsoul-Younes, Gharaibeh, Murtaja), School of Pharmacy, Department of Pediatrics (Masri, Al-Qudah), School of Medicine, University of Jordan, Amman, Jordan
MD, PhD
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Lobna F. Gharaibeh
From the Department of Biopharmaceutics and Clinical Pharmacy (Albsoul-Younes, Gharaibeh, Murtaja), School of Pharmacy, Department of Pediatrics (Masri, Al-Qudah), School of Medicine, University of Jordan, Amman, Jordan
BSc, MSc, PhD
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Amer A. Murtaja
From the Department of Biopharmaceutics and Clinical Pharmacy (Albsoul-Younes, Gharaibeh, Murtaja), School of Pharmacy, Department of Pediatrics (Masri, Al-Qudah), School of Medicine, University of Jordan, Amman, Jordan
BSc, MSc
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Abdelkarim A. Al-Qudah
From the Department of Biopharmaceutics and Clinical Pharmacy (Albsoul-Younes, Gharaibeh, Murtaja), School of Pharmacy, Department of Pediatrics (Masri, Al-Qudah), School of Medicine, University of Jordan, Amman, Jordan
MD, ABCN
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Article Figures & Data

Tables

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    Table 1

    General characteristics of the patients (N=82).

    Characteristicsn (%)
    Gender
    Male50 (61)
    Female32 (39)
    Types of seizures
    Generalized21 (25.6)
    Focal seizures33 (40.2)
    Spasms12 (14.6)
    Mixed seizures16 (19.5)
    Intractability
    Yes45 (54.9)
    No37 (45.1)
    • View popup
    Table 2

    Number of antiepileptic drugs (AEDs) prescribed per patient, number of newer generation AEDs used*, and level of seizure control achieved in patients at enrollment and at the end of one-year follow-up (N=82).

    VariablesAt the start of follow-up, n (%)At the end of follow-up, n (%)
    Number of AEDs prescribed to control seizures
    One AED0 (0)3 (3.7)
    2 AEDs54 (65.9)44 (53.7)
    3 AEDs23 (28.0)26 (31.7)
    4 AEDS5 (6.1)9 (11)
    Number of newer generation AEDs prescribed per patient
    None28 (34.1)28 (34.1)
    One AED40 (48.8)34 (41.5)
    2 AEDs13 (15.9)20 (24.4)
    3 AEDs1 (1.2)0 (0)
    Level of seizure control (%)
    <25%13 (15.9)12 (14.6)
    25<50%4 (4.9)6 (7.3)
    50<75%11 (13.4)15 (18.3)
    75<10021 (25.6)20 (24.4)
    100%33 (40.2)29 (35.4)
    • ↵* When classifying AEDs, the following criteria were used: AEDs that were in clinical use before 1993 were considered to be older generation antiepileptic drugs, which include carbamazepine, phenytoin phenobarbital, ethosuximide, primidone, clonazepam, and valproic acid. While, AEDs approved for clinical use after 1993 were considered newer-generation drugs, including tiagabine, felbamate, gabapentin, oxcarbazepine, zonisamide, lamotrigine, topiramate, and levetiracetam16

    • View popup
    Table 3

    Frequency of adverse drug reactions reported by patients (82) and/or patient’ caregivers during follow-up visits.

    Type of adverse drug reactionn (%)*
    Nervousness and irritability43 (52.4)
    Reduced appetite19 (23.1)
    Sedation16 (19.5)
    Weight gain16 (19.5)
    Hyperactivity15 (18.3)
    Anxiety6 (7.3)
    Behavioral change6 (7.3)
    Hyperthermia6 (7.3)
    Somnolence6 (7.3)
    Gait problems2 (2.4)
    Insomnia2 (2.4)
    Memory loss2 (2.4)
    Rash2 (2.4)
    Weight loss2 (2.4)
    • ↵* The following adverse drug reactions were reported by only one patient: cognitive impairment, constipation, drooling, increased appetite, increased blood pressure, increased heart rate, psychomotor slowing,shortness of breath, tremor, and urinary incontinence. Some patients reported more than one adverse drug reaction at a time

    • View popup
    Table 4

    Average doses (mg) of antiepileptic drugs used in pediatric patients (82) at the beginning and end of the one year follow-up.

    Drug NameFrequency (n)Average Doses (Mean±SD)Min-Maximum Dose
    StartEndStartEndStartEnd
    Valproic Acid5754567.5±342.7626.4±420.9200-2000100-2000
    Levetiracetam3430795.6±479.8893.3±548.2150-2000150-2000
    Carbamazepine3030330.7±160.1364.7±197.1120-70040-800
    Clonazepam2421.1±1.21.7±3.60.2-60.1-20
    Topiramate232386.4±54.271.7±52.325-20012.5-200
    Phenobarbital161046.0±27.146.5±18.015-9015-75
    Lamotrigine810128.1±71.3113.8±95.525-22525-300
    Vigabatrin78517.9±292.5703.1±312.9125-1000125-1000
    Oxcarbazepine11720±0720±0720-720720-720
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Neurosciences Journal: 25 (4)
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Frequency of antiepileptic drugs and response change in pediatric patients receiving 2 or more antiepileptic drugs
Abla M. Albsoul-Younes, Amira T. Masri, Lobna F. Gharaibeh, Amer A. Murtaja, Abdelkarim A. Al-Qudah
Neurosciences Journal Aug 2020, 25 (4) 269-275; DOI: 10.17712/nsj.2020.4.20190113

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Frequency of antiepileptic drugs and response change in pediatric patients receiving 2 or more antiepileptic drugs
Abla M. Albsoul-Younes, Amira T. Masri, Lobna F. Gharaibeh, Amer A. Murtaja, Abdelkarim A. Al-Qudah
Neurosciences Journal Aug 2020, 25 (4) 269-275; DOI: 10.17712/nsj.2020.4.20190113
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