title: Antiepileptic drug interactions.
abstract: BACKGROUND
  Antiepileptics are drugs used in the long-term treatment of epilepsy and other conditions such as pain or psychiatric diseases. They are often administered as polytherapy or in combination with other treatments. It is therefore important to know their potential interactions (with each other and with other substances) in order to avoid altering their efficacy or potentiating their side effects.
  
  
  OBJECTIVE
  The purpose of this article is to review these aspects and stress the most important interactions in day-to-day clinical practice.
  
  
  RESULTS
  Older antiepileptic drugs (AEDs) such as phenytoin, carbamazepine, phenobarbital and valproic acid can significantly interfere not only with each other and other AEDs, but also with other treatments. Although newer AEDs have a more favourable pharmacokinetic profile, they are not entirely exempt from interactions and they are also commonly administered in combination with older AEDs. Another aspect that should be considered is the existence of any clinically important pharmacokinetic and pharmacodynamic interactions in patients requiring the continuous administration of other treatments.
  
  
  CONCLUSIONS
  We must be aware of the pharmacokinetic and pharmacodynamic interactions of AEDs. Because of a lack of significant interactions, drugs such as levetiracetam, gabapentin or pregabalin can be recommended in particular groups such as patients with cancer, transplants, anticoagulant treatments or HIV infection. In all cases, it is important to ensure AED efficacy and prevent serious complications.
authors.affiliation: Department of Neurology, 12 de Octubre Hospital, Madrid, Spain. rsaizdiaz@yahoo.com
authors.forename: Rosa Ana Saiz
authors.initials: RA
authors.lastname: Díaz
authors.forename: Jerónimo
authors.initials: J
authors.lastname: Sancho
authors.forename: José
authors.initials: J
authors.lastname: Serratosa
mesh_terms: D000818:Animals; D000927:Anticonvulsants / Q000494:pharmacology* / Q000627:therapeutic use; D003577:Cytochrome P-450 Enzyme System / Q000502:physiology; D004347:Drug Interactions; D004827:Epilepsy / Q000188:drug therapy; D006801:Humans
chemical_list: D000927:Anticonvulsants; D003577:Cytochrome P-450 Enzyme System