Levetiracetam

MONDAY, June 24, 2024 -- Specific steps can be taken to reduce the risk of potentially fatal reactions to anti-seizure medications, researchers report in a new review. Performing blood tests, asking patients about risk factors and modifying dosages all can reduce reaction risk for drugs that millions of Americans take for epilepsy and other conditions, researchers said. However, rashes and skin reactions in newly medicated patients still require prompt medical attention, results show. Rashes are common with anti-seizure meds, occurring in 2% to 16% of patients, depending on the drug, researchers said in background notes. Roughly 5% of these rashes indicate a life-threatening condition, researchers added. The FDA recently issued a warning about serious reactions to two anti-seizure drugs, levetiracetam and clobazam , the researchers noted. “Dangerous reactions are rare, but patients and caregivers should understand the risk and how to respond if side effects occur,” said lead researcher Dr. Ram Mani , chief of the adult epilepsy division at Rutgers Robert Wood Johnson Medical School in New Jersey. For the new report, published recently in the journal Current Treatment Options in Neurology , researchers analyzed and combined published data on individual anti-seizure drugs, distinguishing the different rashes and their triggers. Genetics can increase a person’s risk of a severe rash, as can interactions between the anti-seizure meds and other drugs, researchers found. Users also are at higher risk if they use aromatic anti-seizure drugs like phenobarbital or carbamazepine , or if doctors rapidly escalate the dosage of their med. A common rash typically affects the torso or limbs with a flat rash or hive-like bumps that occur within two weeks of treatment, researchers said. This rash typically disappears without treatment a few weeks after patients stop taking the drug. But while rare, severe skin conditions also can occur. Stevens-Johnson syndrome and toxic epidermal necrolysis can cause fever, eye pain and detached skin, and it often requires hospitalization. “Patients should seek medical treatment if rashes develop rather than waiting for them to disappear,” said researcher Dr. Cindy Wassef , an assistant professor of dermatology at Robert Wood Johnson Medical School. “If symptoms are mild, they can contact their neurologist or primary care physician, but serious symptoms like a high fever, skin pain, or blisters warrant a trip to the emergency room or a 911 call.” Several thousand patients suffer severe reactions to anti-seizure meds each year, Mani estimated. Those numbers could improve if neurologists take the time to suss out high-risk patients and put them on low-risk drugs. “I gave a talk on this topic at the American Epilepsy Society Conference last year, and I asked the more than 200 doctors in the room how frequently they perform the recommended HLA screening tests on indicated patients, and only a handful raised their hands,” Mani said in a Rutgers news release. “So, there’s definitely room for improvement to increase patient safety.” Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

While older drugs for epilepsy, taken while pregnant, have been shown in previous research to affect the creative thinking of children, a new study finds no effects on creativity for children born to those taking newer epilepsy drugs. While older drugs for epilepsy, taken while pregnant, have been shown in previous research to affect the creative thinking of children, a new study finds no effects on creativity for children born to those taking newer epilepsy drugs. This study is published in the May 29, 2024, online issue of Neurology®, the medical journal of the American Academy of Neurology. Overall, the study found no effects on the children's creative abilities or their executive function, which is a person's ability to plan, focus, and manage multiple tasks. However, when researchers looked only at children with higher concentrations of these medications in the mother's blood during the third trimester, the study found an association with poorer performance in tests of children's executive function, but no effect on their creative abilities. "Our findings highlight that even for epilepsy medications that are generally considered to be safe in pregnancy, dose adjustments should be made with a goal of reaching an optimal balance between controlling seizures and the minimizing negative effects on the developing child," said study author Kimford Meador, MD, PhD, of Stanford University in Palo Alto, California and a Fellow of the American Academy of Neurology. The study involved 251 children of female participants with epilepsy and 73 children of female participants without the disease. Of those with epilepsy, most were taking just one epilepsy medication. Of this group, 81 people were on lamotrigine and 68 people were on levetiracetam. The children were evaluated at age four and a half with a test of creative thinking where they were provided with a shape or figure and responded by completing or adding their own illustrations. This test assesses fluency, flexibility and originality abilities. After adjusting for mothers' IQ and education, researchers found no differences in the creativity scores between the children born to mothers with epilepsy and those born to mothers without the disease. In addition, they found no differences in creativity between the children of mothers with epilepsy that could be linked to different levels of antiseizure medications found in mothers' blood samples during the third trimester. However, researchers found higher third trimester blood concentrations of these medications were associated with poorer performance on tests of executive skills. This link was mainly associated with exposure to levetiracetam. "There is still so much to learn about the impact of a mother's epilepsy medications on their child's creative development," said Meador. "More studies are needed, especially in older children, to assess the full effect of these medications on childhood development." A limitation of the study was that cognitive tests at age four and a half are not as accurate at predicting creativity and thinking skills in the teenage and adult years as tests taken at older ages.