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The article "Multiple drugs: Various toxicities: 5 case reports" discusses five cases of patients, including boys and men aged 10-33 years, who experienced hyperactivity, lack of efficacy, or no drug effect while being treated with risperidone, aripiprazole, fluvoxamine, or off-label lamotrigine for various disorders. The patients had histories of epilepsy, behavioural disorders, severe intellectual disabilities, and mood disorders. Some patients showed improvement with lamotrigine therapy, while others did not respond to the treatments and had to discontinue them. The article highlights the complexities and challenges of treating individuals with different medical conditions and the varying responses to medications. [Extracted from the article]

A female infant with tuberous sclerosis complex and kidney issues showed lack of efficacy with clonazepam, clobazam, vigabatrin, and levetiracetam for seizures. Despite treatment, her seizures remained difficult to manage, leading to referral for surgical therapy. Treatment with sirolimus resulted in size reduction of the renal mass, with complete resolution at 1 year of age. The case highlights the challenges of managing seizures in patients with complex medical conditions. [Extracted from the article]

A case report published in Reactions Weekly describes a male child with tuberous sclerosis complex who exhibited lack of efficacy during treatment with aspirin and enoxaparin-sodium as thromboembolism prophylaxis. The child developed thrombosed aneurysm and thrombus in the upper arm while on aspirin therapy, and later developed a thrombosed pseudoaneurysm and limb ischaemia while on enoxaparin-sodium. He underwent surgeries and developed osteomyelitis, but six months later showed improvement in hand function. The report also mentions that the child demonstrated early symptoms of attention deficit/hyperactivity disorder. [Extracted from the article]

A 19-year-old man developed drug-induced diabetes while being treated with everolimus for tuberous sclerosis complex. He had epilepsy, severe learning disability, and visual impairments. After being hospitalized with sleep disturbance and hyperglycemia, he was diagnosed with everolimus-induced diabetes and treated with gliclazide and metformin. Three months later, his diabetes had improved. [Extracted from the article]

A 34-year-old man experienced a lack of efficacy in his treatment for seizures despite multiple anti-seizure drug regimens. He had his first seizure at the age of 13 and continued to have seizures once or twice a week. After being admitted to the hospital, he was diagnosed with tuberous sclerosis complex. During monitoring, his seizures were recorded and he was started on everolimus treatment, which resulted in a decrease in seizure frequency. The man reported tremors in his hands, leading to the tapering and eventual discontinuation of valproic acid treatment. [Extracted from the article]

A 9-year-old boy with autism spectrum disorders and attention-deficit hyperactivity disorder was initially treated with carbamazepine for seizures related to tuberous sclerosis complex. After the carbamazepine was withdrawn, he experienced a rebound effect and developed seizures. He was then diagnosed with radiologically isolated syndrome and started on interferon-beta-1a, but experienced adverse effects including fever, pain, and psychomotor agitation. His treatment was switched to a different form of interferon-beta-1a with improved tolerability. MRI scans showed stable TSC-related brain lesions and resolution of contrast enhancement. [Extracted from the article]

A man in his mid-20s experienced lack of efficacy and reduced drug levels while being treated for epilepsy with carbamazepine, sodium valproate, and phenobarbital. He also developed cerebellar dysfunction. The man had a history of epilepsy since the age of 12 and had been receiving treatment, but his epilepsy remained uncontrolled. After examination, he was diagnosed with Tuberous sclerosis complex (TRS) and his carbamazepine therapy was stopped. He was discharged with mild to moderate intellectual disability and controlled seizures. The discontinuation of carbamazepine was believed to have reduced the drug level of sodium valproate due to a drug-drug interaction. [Extracted from the article]

In a retrospective observational study, five patients with tuberous sclerosis who were receiving everolimus treatment experienced various toxicities. These included diabetes, leukopenia, neutropenia and COVID-19 infection, cerebral edema, and oral ulceration. Four out of the five patients had to discontinue everolimus treatment. The study did not provide specific information about the patients' ages, sexes, or the details of their treatment. [Extracted from the article]

A 7-year-old girl with tuberous sclerosis complex (TSC) and drug-resistant epilepsy was treated with multiple medications, including antiseizure drugs and drugs for constipation and emesis. Despite undergoing surgery and vagus nerve stimulation (VNS) therapy, her seizures persisted. She also developed daily emesis, which did not improve with various medications. However, after VNS deactivation, her emesis stopped and she gained weight. This case highlights the lack of efficacy of certain drugs in managing epilepsy and associated symptoms in pediatric patients with TSC. [Extracted from the article]

Her medical history included tuberous sclerosis for which, she had been receiving levetiracetam [ I route and dosage not stated i ]. B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 42-year-old woman developed psychosis during treatment with levetiracetam for tuberous sclerosis. After treatment her clinical condition improved; however, the personality traits persisted. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event In a case report of 5 patients, receiving cannabidiol between March 2021 and December 2021, et al. patient [ I age and sex not stated i ] was described, who exhibited lack of efficacy during treatment with cannabidiol and clobazam for Lennox Gastaut Syndrome [LGS; I routes and dosages not stated i ]. The patient with a history of tuberous sclerosis, was commenced on a treatment with cannabidiol and clobazam for LGS-associated multifocal epilepsy. However, the patient did not experience reduction in the intensity of seizures, indicating lack of efficacy to cannabidiol and clobazam. [Extracted from the article]

In the remaining one patient unspecified antiepileptic drugs were reduced with improvement in the agitation and irritability [ I not all outcomes stated i ]. Everolimus effects on tuberous sclerosis complex-associated neuropsychiatric disorders. B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event In a study involving 6 patients treated with everolimus, 2 adult patients including one woman [ I exact age not stated and not all sexes stated i ] were described; who developed confusional state or agitation and irritability during treatment with everolimus for tuberous sclerosis complex associated neuropsychiatric disorders. [Extracted from the article]

Additionally, she exhibited lack of efficacy during treatment with adenosine for supraventricular tachycardia [ I not all dosages and routes stated; time to reaction onset not stated i ]. B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event * Drug interaction A female neonate [ I exact age reaction onset not stated i ] exhibited increased level of sirolimus following pharmacokinetic interaction of amiodarone for supraventricular tachycardia and off-label sirolimus for tuberous sclerosis complex. [Extracted from the article]

During the subsequent years, bilateral renal angiomyolipoma and sub-ependymal giant cell astrocytoma associated with tuberous sclerosis complex were diagnosed. Dose of everolimus was reduced following episodes of aphthous stomatitis; while everolimus was temporarily interrupted during treatment of the febrile episode with zoster-like cutaneous rash on the lower extremity at clinic [ I outcomes not stated i ]. B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 21-year-old woman developed aphthous stomatitis and febrile cutaneous rash on lower extremity during treatment with everolimus for bilateral renal angiomyolipoma and sub-ependymal giant cell astrocytoma associated with tuberous sclerosis complex. [Extracted from the article]

Thereafter, the boy's treatment was started with isotretinoin, and a complete resolution along with significant improvement of angiofibromas was noted after nine months of treatment. B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 17-year-old boy exhibited lack of efficacy during treatment with minocycline for tuberous sclerosis complex. However, no response was noted to the minocycline therapy (indicating lack of efficacy). [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 43-year-old woman developed neutropenia during treatment with cisplatin and irinotecan for oesophagogastric neuroendocrine carcinoma [ I routes and outcome not stated i ]. The dose of cisplatin was reduced to 48 mg/m SP 2 sp (80% of dose). After the first course of chemotherapy, she developed chemotherapy (cisplatin and irinotecan) related side-effect in the form of grade 2 neutropenia. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event In a retrospective cross-sectional analysis of 30 patients, who were diagnosed with tuberous sclerosis complex (TSC) at the National Institutes of Health (NIH) Clinical Center between 2004 and 2019, one patient [ I age and sex not stated i ] was described, who developed painful oral ulcer during treatment with sirolimus for pulmonary lymphangioleiomyomatosis. The patient, who had pulmonary lymphangioleiomyomatosis secondary to TSC, started receiving oral sirolimus [ I dosage not sta i ted]. Subsequently, the patient developed grade 3 painful oral ulcer secondary to sirolimus [ I duration of treatment to reaction onset not stated i ]. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 27-month-old boy developed decreased level of consciousness, pancreatitis and coagulopathy during treatment with valproic acid for refractory epilepsy. He had started receiving therapy with valproic acid 13 months prior to the current presentation and 3 months ago, the dose of valproic acid was increased from 250mg to 300mg twice daily (approximately 38 mg/kg/day). Based on laboratory results and clinical presentation, a provisional diagnosis of valproic acid-induced decreased level of consciousness, pancreatitis and coagulopathy was made [ I times to reactions onsets not stated i ] and hence, valproic acid was stopped. [Extracted from the article]

A 2-month-old girl developed neutropenia during treatment with sirolimus for cardiac rhabdomyoma and prophylactic treatment with levetiracetam for seizures. After a period of sirolimus dose omission until the trough level reached 16.2 µg/L, sirolimus was restarted at 0.125mg dose once a day. A Dramatic Response to Sirolimus Therapy in a Premature Infant With Massive Cardiac Rhabdomyoma. [Extracted from the article]

A 15-year-old boy developed thrombocytopenia and acute kidney injury during treatment with sirolimus for tuberous sclerosis complex (TSC) with lymphangioleiomyomatosis (LAM). However, he could not tolerate sirolimus as he developed thrombocytopenia and acute kidney injury. [Extracted from the article]

Two months later (27 October 2018), the everolimus serum concentration increased to 12.0 g/L while a stable cannabidiol dose of 200 mg/day (9.3 mg/kg/day) was achieved. Cannabidiol and everolimus interaction leading to increased and unstable blood trough levels of everolimus was suspected [ I duration of treatment to reaction onset not stated i ]. The dose of cannabidiol dose was increased to a maximum dose of 500 mg/day (20.4 mg/kg/day). [Extracted from the article]

A 15-year-old girl developed pneumonitis during treatment with everolimus for tuberous sclerosis. Eventually, fungal, mycobacterial and atypical aetiologies were ruled out, and everolimus induced pneumonitis was diagnosed [ I duration of treatment to reaction onset not stated i ]. The girl's everolimus therapy was discontinued, and her treatment was started with unspecified corticosteroids. [Extracted from the article]

A 10-month-old infant [ I sex not stated i ] exhibited increased incidence of pre-existing non-sustained polymorphic ventricular tachycardia (VT) during treatment with everolimus for sporadic cardiac rhabdomyoma. Following approximately 4 months of therapy, at the age of 14 months, the infant exhibited an episode of persistent adenovirus pneumonia and gastroenteritis. Two weeks following the discontinuation of everolimus therapy, Holter monitoring showed sinus tachycardia with right bundle branch block without any evidence of VT. [Extracted from the article]

The article presents case studies of a 48-year-old woman and a 36-year-old woman who developed increased levels of serum creatinine and proteinuria after treatment with everolimus for tuberous sclerosis complex-related renal angiomyolipoma (RAML).

The article presents a case study of 14 patients who experienced grade 3 adverse event of stomatitis while being medicated with everolimus for tuberous sclerosis.

The article presents a case study of a woman who developed hyperlipidaemia, hypertriglyceridaemia, bronchitis, upper respiratory infection and urinary tract infections after receiving sirolimus treatment for tuberous sclerosis complex (TSC).

An abstract of the article "Case report of vigabatrin related MRI changes" by K. Prematunga and others is presented.