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Lamotrigine may be most effective antiepileptic drug
Of 10 antiepileptic drugs (AEDs) studied in older adults with epilepsy, lamotrigine closely followed by levetiracetam is the most effective, as measured by 12-month retention and freedom from seizures, while oxcarbazepine is consistently less effective than other AEDs, according to research published in the April issue of the Archives of Neurology, as reported by HealthDay News.
Of 10 antiepileptic drugs (AEDs) studied in older adults with epilepsy, lamotrigine closely followed by levetiracetam is the most effective, as measured by 12-month retention and freedom from seizures, while oxcarbazepine is consistently less effective than other AEDs, according to research published in the April issue of the Archives of Neurology, as reported by HealthDay News.
Hiba Arif, MD, of Columbia University, New York, and colleagues conducted a retrospective review of 417 patients aged 55 years and older who were newly taking any of 10 commonly prescribed AEDs between 2000 and 2005. Twelve-month retention rates, seizure-free rates, and adverse effects leading to dose change were determined for each AED studied.
The researchers found that lamotrigine had the highest 12-month retention rate (79%) and the highest 12-month seizure-freedom rate (54%). Levetiracetam was second-highest in 12-month retention (73%) and 12-month seizure-freedom (43%). The retention rate was 48% for carbamazepine; 59% for gabapentin; 24% for oxcarbazepine; 59% for phenytoin; and 56% for topiramate. The most common intolerable adverse effects were drowsiness, imbalance, and gastrointestinal symptoms.
“This study underscores the need for further prospective trials for evaluating safety and effectiveness of multiple AEDs in older adults, a cohort that has been consistently underrepresented in prior studies, and suggests that lamotrigine and levetiracetam should be included in any future trials of treatment of epilepsy in older adults,” the authors write.
Several of the study authors reported financial relationships with the pharmaceutical industry.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
