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Research background and purpose Behavior and mental adverse reactions can affect the quality of life of patients with epilepsy.
It is not only a common cause of interruption of anti-epileptic drug treatment, but also has a negative impact on the quality of life of most patients with epilepsy.
Therefore, it is important to consider when choosing anti-epileptic drugs.
The purpose of this review is to understand the occurrence of behavioral adverse reactions (irritability, anger, and aggression) in patients with epilepsy treated with antiepileptic drugs including Buwaracetam, Levetiracetam, Perampanel, and Topiramate in real-world studies after marketing.
Rate and the resulting treatment interruption rate.
The research method searched the Cochrane Library, PubMed/MEDLINE and Embase databases from October 2018 to October 2019.
The system evaluates the incidence of irritability, anger, and aggression of the four anti-epileptic drugs and the resulting treatment interruption rate, and calculates a weighted average when possible.
Research results This systematic review included 42 studies and 7 clinical trial records, with a total of 1500 data, including 25 retrospective studies, 16 prospective and observational studies, and 1 cross-sectional study.
➤The incidence of behavioral adverse reactions of anti-epileptic drugs in real-world studies: As shown in Figure 1, the incidence of irritability, anger, and aggression: topiramate is lower than perampanel, levetiracetam, and brivaracetam .
Figure 1 A summary of the incidence of irritability, anger, or aggression in patients with epilepsy treated with Buwaxitam, Levetiracetam, Perampanel, and Topiramate in a real-world study ➤ Anti-epileptic drugs in real-world studies due to poor behavior Treatment interruption rate caused by response: As shown in Figure 2, the treatment interruption rate due to irritability and aggression: topiramate is lower than levetiracetam and perampanel; no studies have reported the causes of these 4 antiepileptic drugs Rate of treatment interruptions caused by anger.
Figure 2 In a real-world study, the treatment interruption rate of Buwaxitan, Levetiracetam, Perampanel, and Topiramate in the treatment of epilepsy patients due to irritability or aggression is summarized and discussed by the weighted average value.
In clinical practice , Perampanel and Levetiracetam are more irritable than Buwaxitan and Topiramate.
Perampanel often experienced anger, followed by Levetiracetam and Buwaxitan.
Brivaracetam, levetiracetam, and perampanel are more prone to aggressive behavior than topiramate.
Topiramate has multiple mechanisms of action, including acting on voltage-gated sodium channels, GABAA receptors, AMPA/KA receptors and carbonic anhydrase.
All these mechanisms of action work together to exert anti-epileptic effects.
Compared with other anti-epileptic drugs in this review, Topiramate has a lower incidence of behavioral adverse reactions.
Conclusion This review focuses on describing the adverse reactions of irritability, anger and aggressive behavior in patients with epilepsy in the real world of clinical practice taking Buwaxitam, Levetiracetam, Perampanel, and Topiramate, which can help clinicians Understand the risk of behavioral adverse reactions to different antiepileptic drugs, so as to better discuss treatment options with epilepsy patients.
Literature index: A, Bernhard J.
Steinhoff, et al.
"Behavioraladverse events with brivaracetam, levetiracetam, perampanel, and topiramate: A systematic review.
" Epilepsy & Behavior 118.
1(2021):107939.
It is not only a common cause of interruption of anti-epileptic drug treatment, but also has a negative impact on the quality of life of most patients with epilepsy.
Therefore, it is important to consider when choosing anti-epileptic drugs.
The purpose of this review is to understand the occurrence of behavioral adverse reactions (irritability, anger, and aggression) in patients with epilepsy treated with antiepileptic drugs including Buwaracetam, Levetiracetam, Perampanel, and Topiramate in real-world studies after marketing.
Rate and the resulting treatment interruption rate.
The research method searched the Cochrane Library, PubMed/MEDLINE and Embase databases from October 2018 to October 2019.
The system evaluates the incidence of irritability, anger, and aggression of the four anti-epileptic drugs and the resulting treatment interruption rate, and calculates a weighted average when possible.
Research results This systematic review included 42 studies and 7 clinical trial records, with a total of 1500 data, including 25 retrospective studies, 16 prospective and observational studies, and 1 cross-sectional study.
➤The incidence of behavioral adverse reactions of anti-epileptic drugs in real-world studies: As shown in Figure 1, the incidence of irritability, anger, and aggression: topiramate is lower than perampanel, levetiracetam, and brivaracetam .
Figure 1 A summary of the incidence of irritability, anger, or aggression in patients with epilepsy treated with Buwaxitam, Levetiracetam, Perampanel, and Topiramate in a real-world study ➤ Anti-epileptic drugs in real-world studies due to poor behavior Treatment interruption rate caused by response: As shown in Figure 2, the treatment interruption rate due to irritability and aggression: topiramate is lower than levetiracetam and perampanel; no studies have reported the causes of these 4 antiepileptic drugs Rate of treatment interruptions caused by anger.
Figure 2 In a real-world study, the treatment interruption rate of Buwaxitan, Levetiracetam, Perampanel, and Topiramate in the treatment of epilepsy patients due to irritability or aggression is summarized and discussed by the weighted average value.
In clinical practice , Perampanel and Levetiracetam are more irritable than Buwaxitan and Topiramate.
Perampanel often experienced anger, followed by Levetiracetam and Buwaxitan.
Brivaracetam, levetiracetam, and perampanel are more prone to aggressive behavior than topiramate.
Topiramate has multiple mechanisms of action, including acting on voltage-gated sodium channels, GABAA receptors, AMPA/KA receptors and carbonic anhydrase.
All these mechanisms of action work together to exert anti-epileptic effects.
Compared with other anti-epileptic drugs in this review, Topiramate has a lower incidence of behavioral adverse reactions.
Conclusion This review focuses on describing the adverse reactions of irritability, anger and aggressive behavior in patients with epilepsy in the real world of clinical practice taking Buwaxitam, Levetiracetam, Perampanel, and Topiramate, which can help clinicians Understand the risk of behavioral adverse reactions to different antiepileptic drugs, so as to better discuss treatment options with epilepsy patients.
Literature index: A, Bernhard J.
Steinhoff, et al.
"Behavioraladverse events with brivaracetam, levetiracetam, perampanel, and topiramate: A systematic review.
" Epilepsy & Behavior 118.
1(2021):107939.
