1. Carbamazepine and oxcarbazepine in adult patients with Dravet syndrome: Friend or foe?
- Author
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Snoeijen-Schouwenaars FM, Veendrick MJ, van Mierlo P, van Erp G, de Louw AJ, Kleine BU, Schelhaas HJ, and Tan IY
- Subjects
- Adult, Anticonvulsants adverse effects, Carbamazepine adverse effects, Epilepsies, Myoclonic genetics, Epilepsies, Myoclonic mortality, Female, Humans, Inpatients, Male, Middle Aged, NAV1.1 Voltage-Gated Sodium Channel genetics, Oxcarbazepine, Retrospective Studies, Seizures drug therapy, Seizures genetics, Seizures mortality, Tertiary Care Centers, Voltage-Gated Sodium Channel Blockers adverse effects, Young Adult, Anticonvulsants therapeutic use, Carbamazepine analogs & derivatives, Carbamazepine therapeutic use, Epilepsies, Myoclonic drug therapy, Substance Withdrawal Syndrome, Voltage-Gated Sodium Channel Blockers therapeutic use
- Abstract
Purpose: In newly diagnosed patients with Dravet syndrome sodium channel blockers are usually avoided. However, in many adult patients the diagnosis was made long after the initiation of therapy. The purpose of our study was to acquire information concerning the potential risks and benefits of (ox)carba(ma)zepine withdrawal in adult patients with genetically confirmed Dravet syndrome., Method: We identified 16 adults with Dravet syndrome, living in a tertiary care facility for people with epilepsy and an intellectual disability. We reviewed clinical history, genetic findings, the type and duration of sodium channels blockers that were used, seizure types and frequency, and the effect of a change in these medications., Results: The study population consisted of 9 men and 7 women. Median age was 35 years (range 20-61 years). An attempt to withdraw carbamazepine (CBZ) was made in 9 patients. In 3 of these patients an increase in tonic-clonic seizures was observed. An attempt to withdraw oxcarbazepine (OXC) was made in 3 patients, leading to a complete stop in 2 patients. 3 of the 4 deaths in the withdrawal-group were related to epilepsy., Conclusion: In adult patients with Dravet syndrome withdrawal of CBZ or OXC is not without risks. We suggest that (ox)carba(ma)zepine withdrawal should be considered in these patients but only if there is a good reason to do so and only if they are closely monitored., (Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2015
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