[Adverse effects of antiepileptic drugs]

Nihon Rinsho. 2014 May;72(5):908-19.
[Article in Japanese]

Abstract

Adverse effects of antiepileptic drugs are classified into idiosyncratic adverse effects, pharmacology-related adverse effects and biological effect after modification of seizure frequencies. Pharmacology-related adverse effects include those by administered AED and those by mutual interactions. Stevens-Johnson syndrome, one of the idiosyncratic adverse effects, may be predicted by the intrinsic HLA type (e.g., A*31:01 for CBZ). In epileptic patients after acute encephalitis, cutaneous adverse reactions usually occur in a month after encephalitis, but some patients will tolerate the causative AED by the extremely slow re-introduction. Prevention of pharmacology-related adverse effects needs therapeutic drug monitoring, and slow introduction considering dose-response curves for AEDs. Genotype examination of CYP2C9 and 2C19 can contribute to the safe introduction of PHT.

Publication types

  • Review

MeSH terms

  • Anemia, Aplastic / chemically induced
  • Anemia, Aplastic / prevention & control
  • Anticonvulsants / administration & dosage
  • Anticonvulsants / adverse effects*
  • Aryl Hydrocarbon Hydroxylases / genetics
  • Chemical and Drug Induced Liver Injury / etiology
  • Chemical and Drug Induced Liver Injury / prevention & control
  • Cytochrome P-450 CYP2C19
  • Cytochrome P-450 CYP2C9
  • Drug Monitoring
  • Encephalitis / chemically induced
  • Encephalitis / prevention & control
  • Genotype
  • HLA Antigens
  • Humans
  • Severity of Illness Index
  • Stevens-Johnson Syndrome / etiology
  • Stevens-Johnson Syndrome / genetics
  • Stevens-Johnson Syndrome / prevention & control

Substances

  • Anticonvulsants
  • HLA Antigens
  • CYP2C9 protein, human
  • Cytochrome P-450 CYP2C9
  • Aryl Hydrocarbon Hydroxylases
  • CYP2C19 protein, human
  • Cytochrome P-450 CYP2C19