The role of the old and the new antiepileptic drugs in special populations: mental and multiple handicaps.
Epilepsy is common in individuals who are mentally retarded and/or otherwise multiply handicapped. These patients often display several seizure types. Seizure control may be difficult and drug interactions common because of polytherapy. Cognitive, behavioral, affective, and motor problems in these patients often confound accurate diagnosis and effective management. Treatment often requires not only antiepileptic drugs (AEDs) but also psychoactive drugs and/or environmental and personal support. To minimize unwanted drug effects, therapeutic strategies should focus on the administration of the fewest possible drugs at the lowest effective dose. The new AEDs may be of special value at times in these populations because they offer potential for improved efficacy, but especially because many of them provide better safety profiles and fewer pharmacokinetic interactions with other drugs.
Mattson
R H
RH
Department of Neurology, Yale University School of Medicine, New Haven, CT 06511, USA.
D000085:Acetates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000588:Amines; D000927:Anticonvulsants / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy; D003509:Cyclohexanecarboxylic Acids; D006233:Persons with Disabilities; D004334:Drug Administration Schedule; D004347:Drug Interactions; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy*; D000078328:Felbamate; D000077206:Gabapentin; D006801:Humans; D008607:Intellectual Disability / Q000150:complications* / Q000188:drug therapy; D048448:Phenylcarbamates; D019338:Polypharmacy; D011409:Propylene Glycols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D020888:Vigabatrin; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use
D000085:Acetates; D000588:Amines; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D048448:Phenylcarbamates; D011409:Propylene Glycols; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D020888:Vigabatrin; D000078328:Felbamate