Treatment of epilepsy in patients with Alzheimer's disease

Expert Rev Neurother. 2017 Mar;17(3):309-318. doi: 10.1080/14737175.2017.1243469. Epub 2016 Oct 11.

Abstract

Epilepsy is significantly more frequent in AD patients than in age-matched controls, even though the true extent of the phenomenon is not clear yet. Areas covered: In this review, we describe in detail the available data on the pharmacological treatment of epilepsy in patients with AD. We also briefly describe general principles of AEDs use in elderly, as well as the potential cognitive profile of AEDs and safety of concomitant psychotropic drugs in patients with epilepsy and AD. Expert commentary: As some preclinical data suggest a role of epileptiform discharges in cognitive decline in AD, a prompt diagnosis and treatment of seizures in these patients should be pursued. The few data on the use of AEDs in AD patients suggest that newer AEDs (in particular lamotrigine and levetiracetam) might be good choices. Experimental data even support a potential role of some AEDs in modifying the disease course of AD.

Keywords: Alzheimer’s disease; EEG; antiepileptic drugs; complex partial seizures; dementia; elderly patients; epilepsy; focal epilepsy; generalized epilepsy; pharmacokinetics.

Publication types

  • Review

MeSH terms

  • Alzheimer Disease / complications
  • Anticonvulsants / therapeutic use*
  • Epilepsy / complications
  • Epilepsy / drug therapy*
  • Humans
  • Levetiracetam
  • Piracetam / analogs & derivatives
  • Piracetam / therapeutic use
  • Seizures / drug therapy

Substances

  • Anticonvulsants
  • Levetiracetam
  • Piracetam