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Antiepileptic drugs for older people

  • Peter Burbridge (a1), Stephen Allen (a1), Michael Vassallo (a1) and Joseph Kwan (a1)
Abstract

Epilepsy in older people is a common problem. It is estimated that in Europe there are 85 000 new cases of epilepsy annually in those over 65 years old, equivalent to an incidence of 100 per 100 000. Incidence increases with age and the rate in older people is higher than in all but the first year of life. The older population has a median prevalence of 4.7 per 1000 (range 3.0 to 7.3) from nine studies and may be underestimated by case-ascertainment bias common to many studies of older people.

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Corresponding author
Address for correspondence: PM Burbridge, Elderly Care Medicine, Royal Berkshire NHS Foundation Trust, London Road, Reading RG1 5AN, UK.
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1 L Forsgren , E Beghi , A Oun , M Sillanpaa . The epidemiology of epilepsy in Europe – a systematic review. Eur J Neurol 2005; 12:245–53.

3 SD Lhatoo , JW Sander . Cause-specific mortality in epilepsy. Epilepsia 2005; 46 (suppl 11):3639.

4 MJ Pugh , J Cramer , J Knoefel Potentially inappropriate antiepileptic drugs for elderly patients with epilepsy. J Am Geriatr Soc 2004; 52:417–22.

5 MJV Pugh , AC Van Cott , JA Cramer Trends in antiepileptic drug prescribing for older patients with new-onset epilepsy: 2000–2004. Neurology 2008; 70:2171–78.

8 CA Galimberti , F Magri , B Magnani Antiepileptic drug use and epileptic seizures in elderly nursing home residents: a survey in the province of Pavia, Northern Italy. Epilepsy Res 2006; 68:18.

9 SL Harms , LE Eberly , JM Garrard Prevalence of appropriate and problematic antiepileptic combination therapy in older people in the nursing home. J Am Geriatr Soc 2005; 53:1023–08.

10 F Huying , S Klimpe , KJ Werhahn . Antiepileptic drug use in nursing home residents: a cross-sectional, regional study. Seizure 2006; 15:194–97.

11 J Loiseau , P Loiseau , B Duche A survey of epileptic disorders in southwest France: seizures in elderly patients. Ann Neurol 1990; 27:232–37.

12 SM LaRoche , SL Helmers . Epilepsy in the elderly. Neurologist 2003; 9:241–49.

13 WA Hauser , JF Annegers , LT Kurland . Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935–1984. Epilepsia 1993; 34:453–68.

14 MJ Brodie , P Kwan . Epilepsy in elderly people. BMJ 2005; 331:1317–22.

15 YM Hart , JW Sander , AL Johnson , SD Shorvon . National General Practice Study of Epilepsy: recurrence after a first seizure. Lancet 1990; 336:1271–74.

16 WA Hauser , SS Rich , Lee JR, JF Annegers , VE Anderson . Risk of recurrent seizures after two unprovoked seizures. N Engl J Med 1998; 338:429–34.

17 A Marson , A Jacoby , A Johnson Immediate versus deferred antiepileptic drug treatment for early epilepsy and single seizures: a randomised controlled trial. Lancet. 2005; 365:2007–13.

18 LG Kim , TL Johnson , AG Marson , DW Chadwick . Prediction of risk of seizure recurrence after a single seizure and early epilepsy: further results from the MESS trial. Lancet Neurol 2006; 5:317–22.

19 I Drury , A Beydoun . Interictal epileptiform activity in elderly patients with epilepsy. Electroencephalogr Clin Neurophysiol 1998; 106:369–73.

20 CF Bladin , AV Alexandrov , A Bellavance Seizures after stroke: a prospective multicenter study. Arch Neurol 2000; 57:1617–22.

21 C Lamy , V Domigo , F Semah Early and late seizures after cryptogenic ischemic stroke in young adults. Neurology 2003; 60:400–04.

22 MI Lossius , OM Ronning , GD Slapo , P Mowinckel , L Gjerstad . Poststroke epilepsy: occurrence and predictors–a long-term prospective controlled study (Akershus Stroke Study). Epilepsia 2005; 46:1246–51.

23 TS Olsen . Post-stroke epilepsy. Curr Atheroscler Rep 2001; 3:340–44.

24 CY Sung , NS Chu . Epileptic seizures in thrombotic stroke. J Neurol 1990; 237:166–70.

25 DC Hesdorffer , WA Hauser , JF Annegers , E Kokmen , WA Rocca . Dementia and adult-onset unprovoked seizures. Neurology 1996; 46:727–30.

26 JC Amatniek , WA Hauser , C Del Castillo-Castaneda Incidence and predictors of seizures in patients with Alzheimer's disease. Epilepsia 2006; 47: 867–72.

27 G Kramer . Epilepsy in the elderly: some clinical and pharmacotherapeutic aspects. Epilepsia 2001; 42 (suppl 3):59.

28 R Mohanraj , MJ Brodie . Diagnosing refractory epilepsy: response to sequential treatment schedules. Eur J Neurol 2006; 13:277–82.

29 E Faught . Monotherapy in adults and elderly persons. Neurology 2007; 69 (suppl 3): S39.

31 A Piazzini , MP Canevini , K Turner , R Chifari , R Canger . Elderly people and epilepsy: cognitive function. Epilepsia 2006; 47 (suppl 5):8284.

32 T Glauser , E Ben-Menachem , B Bourgeois ILAE treatment guidelines: evidence-based analysis of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes. Epilepsia 2006; 47:1094–20.

33 AJ Rowan , RE Ramsay , JF Collins New-onset geriatric epilepsy: a randomized study of gabapentin, lamotrigine, and carbamazepine. Neurology 2005; 64:1868–73.

34 MJ Brodie , PW Overstall , L Giorgi . Multicentre, double-blind, randomised comparison between lamotrigine and carbamazepine in elderly patients with newly diagnosed epilepsy. The UK Lamotrigine Elderly Study Group. Epilepsy Res 1999; 37:8187.

35 MD Privitera , MJ Brodie , RH Mattson Topiramate, carbamazepine and valproate monotherapy: double-blind comparison in newly diagnosed epilepsy. Acta Neurol Scand 2003; 107:165–75.

36 E Saetre , E Perucca , J Isojarvi , L Gjerstad . An international multicenter randomized double-blind controlled trial of lamotrigine and sustained-release carbamazepine in the treatment of newly diagnosed epilepsy in the elderly. Epilepsia 2007; 48:1292–302.

37 AG Marson , AM Al-Kharusi , M Alwaidh The SANAD study of effectiveness of carbamazepine, gabapentin, lamotrigine, oxcarbazepine, or topiramate for treatment of partial epilepsy: an unblinded randomised controlled trial. Lancet 2007; 369:1000–15.

38 JA Cramer , IE Leppik , KD Rue , P Edrich , G Kramer . Tolerability of levetiracetam in elderly patients with CNS disorders. Epilepsy Res 2003; 56:135–45.

39 TM Alsaadi , S Koopmans , M Apperson , S Farias . Levetiracetam monotherapy for elderly patients with epilepsy. Seizure 2004; 13:5860.

40 JA Ferrendelli , J French , I Leppik Use of levetiracetam in a population of patients aged 65 years and older: a subset analysis of the KEEPER trial. Epilepsy Behav 2003; 4:702–09.

41 J Bauer , E Ben-Menachem , G Kramer Levetiracetam: a long-term follow-up study of efficacy and safety. Acta Neurol Scand 2006; 114:169–76.

42 J Groselj , R Guerrini , J Van Oene Experience with topiramate monotherapy in elderly patients with recent-onset epilepsy. Acta Neurol Scand 2005; 112:144–50.

43 E Kutluay , K McCague , J D'Souza , A Beydoun . Safety and tolerability of oxcarbazepine in elderly patients with epilepsy. Epilepsy Behav 2003; 4:175–80.

44 RH Mattson , JA Cramer , JF Collins . A comparison of valproate with carbamazepine for the treatment of complex partial seizures and secondarily generalized tonic-clonic seizures in adults. The Department of Veterans Affairs Epilepsy Cooperative Study No. 264 Group. N Engl J Med 1992; 327:765–71.

46 A Birnbaum , NA Hardie , IE Leppik Variability of total phenytoin serum concentrations within elderly nursing home residents. Neurology 2003; 60:555–59.

47 PN Patsalos , DJ Berry , BF Bourgeois Antiepileptic drugs–best practice guidelines for therapeutic drug monitoring: a position paper by the subcommission on therapeutic drug monitoring, ILAE Commission on Therapeutic Strategies. Epilepsia 2008; 49:1239–76.

49 HB Newton , SA Goldlust , D Pearl . Retrospective analysis of the efficacy and tolerability of levetiracetam in brain tumor patients. J Neurooncol 2006; 78:99102.

50 CJ Vecht , GL Wagner , EB Wilms . Interactions between antiepileptic and chemotherapeutic drugs. Lancet Neurol 2003; 2:404–09.

51 KE Ensrud , TS Walczak , T Blackwell Antiepileptic drug use increases rates of bone loss in older women: a prospective study. Neurology 2004; 62:2051–57.

52 Y Sato , I Kondo , S Ishida Decreased bone mass and increased bone turnover with valproate therapy in adults with epilepsy. Neurology 2001; 57:445–49.

53 S Mintzer , P Boppana , J Toguri , A DeSantis . Vitamin D levels and bone turnover in epilepsy patients taking carbamazepine or oxcarbazepine. Epilepsia 2006; 47:510–15.

55 HB Persson , KA Alberts , BY Farahmand , T Tomson . Risk of extremity fractures in adult outpatients with epilepsy. Epilepsia 2002; 43:768–72.

56 RD Sheth , CL Harden . Screening for bone health in epilepsy. Epilepsia 2007; 48 (suppl 9):3941.

57 G Kenneback , M Ericson , T Tomson , L Bergfeldt . Changes in arrhythmia profile and heart rate variability during abrupt withdrawal of antiepileptic drugs. Implications for sudden death. Seizure 1997; 6:369–75.

58 TD Fife , D Blum , RS Fisher . Measuring the effects of antiepileptic medications on balance in older people. Epilepsy Res 2006; 70:103–09.

59 KE Ensrud , TL Blackwell , CM Mangione Central nervous system-active medications and risk for falls in older women. J Am Geriatr Soc 2002; 50:1629–37.

60 P Ryvlin , A Montavont , N Nighoghossian . Optimizing therapy of seizures in stroke patients. Neurology 2006; 67 (suppl 4):S39.

62 LB Goldstein . Common drugs may influence motor recovery after stroke. The Sygen In Acute Stroke Study Investigators. Neurology 1995; 45:8651071.

63 AM Naidech , KT Kreiter , N Janjua Phenytoin exposure is associated with functional and cognitive disability after subarachnoid hemorrhage. Stroke 2005; 36:583–87.

64 J Alvarez-Sabin , J Montaner , L Padro Gabapentin in late-onset poststroke seizures. Neurology. 2002; 59:1991–93.

67 PN Patsalos , E Perucca . Clinically important drug interactions in epilepsy: interactions between antiepileptic drugs and other drugs. Lancet Neurol 2003; 2:473–81.

68 KJ Goulden , JM Dooley , PR Camfield , AD Fraser . Clinical valproate toxicity induced by acetylsalicylic acid. Neurology 1987; 37:1392–94.

69 NB Sandson , C Marcucci , DL Bourke , R Smith-Lamacchia . An interaction between aspirin and valproate: the relevance of plasma protein displacement drug-drug interactions. Am J Psychiatry 2006; 163:1891–96.

72 KJ Meador . Cognitive outcomes and predictive factors in epilepsy. Neurology 2002; 58 (suppl 5):S2126.

73 C Cordonnier , H Henon , P Derambure , F Pasquier , D Leys . Early epileptic seizures after stroke are associated with increased risk of new-onset dementia. J Neurol Neurosurg Psychiatry 2007; 78:514–16.

74 K Turnheim . When drug therapy gets old: pharmacokinetics and pharmacodynamics in the elderly. Exp Gerontol 2003; 38:843–53.

75 HR Griffith , RC Martin , JK Bambara , DC Marson , E Faught . Older adults with epilepsy demonstrate cognitive impairments compared with patients with amnestic mild cognitive impairment. Epilepsy Behav 2006; 8:161–68.

76 DB Smith , RH Mattson , JA Cramer Results of a nationwide Veterans Administration Cooperative Study comparing the efficacy and toxicity of carbamazepine, phenobarbital, phenytoin, and primidone. Epilepsia 1987; 28 (suppl 3):S5058.

77 WO Tatum , JA French , E Faught Postmarketing experience with topiramate and cognition. Epilepsia 2001; 42:1134–40.

78 AP Aldenkamp , G Baker , OG Mulder A multicenter, randomized clinical study to evaluate the effect on cognitive function of topiramate compared with valproate as add-on therapy to carbamazepine in patients with partial-onset seizures. Epilepsia 2000; 41:1167–78.

79 AP Aldenkamp , J Arends , HP Bootsma Randomized double-blind parallel-group study comparing cognitive effects of a low-dose lamotrigine with valproate and placebo in healthy volunteers. Epilepsia 2002; 43:1926.

80 JS Aulakh , JW Hawkins , HS Athwal Tolerability and effectiveness of lamotrigine in complex elderly patients. J Geriatr Psychiatry Neurol 2005; 18:811.

81 KJ Meador , DW Loring , PG Ray Differential cognitive and behavioral effects of carbamazepine and lamotrigine. Neurology 2001; 56:1177–82.

82 V Belcastro , C Costa , F Galletti Levetiracetam monotherapy in Alzheimer patients with late-onset seizures: a prospective observational study. Eur J Neurol 2007; 14:1176–68.

83 HH Kyomen , TH Whitfield , RJ Baldessarini . Levetiracetam for manic behavior in hospitalized geriatric patients with dementia of the Alzheimer's type. J Clin Psychopharmacol 2007; 27:408–10.

85 GK Bergey . Initial treatment of epilepsy: special issues in treating the elderly. Neurology 2004; 63 (suppl 4):S4048.

86 DP McLaughlin , NA Pachana , K McFarland . Depression in a community-dwelling sample of older adults with late-onset or lifetime epilepsy. Epilepsy Behav 2008; 12:281–85.

87 E Perucca , D Berlowitz , A Birnbaum Pharmacological and clinical aspects of antiepileptic drug use in the elderly. Epilepsy Res 2006; 68 (suppl 1):S4963.

88 RV Sheorajpanday , PP De Deyn . Epileptic fits and epilepsy in the elderly: general reflections, specific issues and therapeutic implications. Clin Neurol Neurosurg 2007; 109:727–43.

90 V Biton , W Mirza , G Montouris Weight change associated with valproate and lamotrigine monotherapy in patients with epilepsy. Neurology 2001; 56:172–77.

91 E Faught , R Ayala , GG Montouris , IE Leppik . Randomized controlled trial of zonisamide for the treatment of refractory partial-onset seizures. Neurology 2001; 57:1774–79.

92 E Ben-Menachem , M Axelsen , EH Johanson , A Stagge , U Smith . Predictors of weight loss in adults with topiramate-treated epilepsy. Obes Res 2003; 11:556–62.

93 AM Chihorek , B Abou-Khalil , BA Malow . Obstructive sleep apnea is associated with seizure occurrence in older adults with epilepsy. Neurology 2007; 69:1823–27.

94 M Nieto-Barrera , M Brozmanova , G Capovilla A comparison of monotherapy with lamotrigine or carbamazepine in patients with newly diagnosed partial epilepsy. Epilepsy Res 2001; 46:145–55.

95 JC Cloyd , RP Remmel . Antiepileptic drug pharmacokinetics and interactions: impact on treatment of epilepsy. Pharmacotherapy 2000; 20 (Pt 2):139S–51S.

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Reviews in Clinical Gerontology
  • ISSN: 0959-2598
  • EISSN: 1469-9036
  • URL: /core/journals/reviews-in-clinical-gerontology
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