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Adverse effects of anti‐epileptics in trigeminal neuralgiform pain
Author(s) -
TentolourisPiperas V.,
Lee G.,
Reading J.,
O'Keeffe A. G.,
Zakrzewska J. M.,
Cregg R.
Publication year - 2018
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12901
Subject(s) - oxcarbazepine , lamotrigine , medicine , carbamazepine , trigeminal neuralgia , adverse effect , side effect (computer science) , epilepsy , neuropsychology , drug , anesthesia , observational study , cognition , psychiatry , computer science , programming language
Background Side effects of anti‐epileptic drugs ( AED s) have not been adequately documented in trigeminal neuralgia and its variants. The aim of this observational cross‐sectional study was to compare the A‐B Neuropsychological Assessment Schedule ( ABNAS ), which measures cognitive side effects to the Adverse Events Profile ( AEP ), which looks at a broader range of side effects, and to investigate drug/dosage relationships with questionnaire scores to help determine a point at which a drug change would be indicated. Methods One hundred five patients were recruited from a facial pain clinic, over a 10‐month period. Self‐complete questionnaire scores were compared between patients using different AED s. Results A‐B Neuropsychological Assessment Schedule score correlated well with AEP indicating that cognitive side effects were a significant burden. Toxic range on the ABNAS was estimated to occur when scores were >43/72 (95% CI : 37.4‐48.6). Polytherapy is weakly associated with the higher scores. Oxcarbazepine dosage was found to linearly correlate with AEP and ABNAS scores, better than carbamazepine dosage. Memory alteration was least common with lamotrigine and oxcarbazepine, and there was less association between fatigues with oxcarbazepine/pregabalin. Conclusion Anti‐epileptic drugs have significant side effects. The ABNAS questionnaire is a useful tool along with the AEP to recognize and monitor AED s’ side effects and to help to adjust medications to optimal dosage.