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Neuropsychiatric adverse events of antiepileptic drugs in brain tumour‐related epilepsy: an Italian multicentre prospective observational study
Author(s) -
Bedetti C.,
Romoli M.,
Maschio M.,
Di Bonaventura C.,
Nardi Cesarini E.,
Eusebi P.,
Siliquini S.,
Dispenza S.,
Calabresi P.,
Costa C.
Publication year - 2017
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13375
Subject(s) - medicine , levetiracetam , epilepsy , adverse effect , observational study , prospective cohort study , odds ratio , neurosurgery , oligodendroglioma , pediatrics , anesthesia , psychiatry , glioma , cancer research , astrocytoma
Background and purpose We assessed the prevalence and magnitude of neuropsychiatric adverse events ( NPAE s) associated with antiepileptic drugs ( AED s) among patients with brain tumour‐related epilepsy ( BTRE ). Methods This observational, prospective, multicentre study enrolled 259 patients with BTRE after neurosurgery. All patients received AED monotherapy. Efficacy was assessed through clinical diaries, whereas NPAE s were collected using the Neuropsychiatric Inventory Test‐12 questionnaire at baseline and after 5 months. Results Tumour localization in the frontal lobe was associated with a higher prevalence of NPAE s (odds ratio, 7.73; P < 0.001). Independent of tumour localization, levetiracetam ( LVT) treatment was associated with higher prevalence and magnitude of NPAE s (odds ratio, 7.94; P < 0.01) compared with other AED s. Patients with oligodendroglioma reported more NPAE s than patients with other tumour types. NPAE s were not influenced by chemotherapy, radiotherapy or steroid treatment. Evaluating non‐neurobehavioural adverse events of AED s, no significant differences were found among AED s, although patients treated with old AED s had a higher prevalence of adverse events than those treated with new AED s. Conclusions Both tumour localization in the frontal lobe and LVT treatment are associated with a higher risk of NPAE s in patients with BTRE . LVT is regarded as a first‐line option in patients with BTRE because of easy titration and few significant drug‐to‐drug interactions. Thus, as NPAE s lead to poor compliance and a high dropout rate, clinicians need to accurately monitor NPAE s after AED prescription, especially in patients with frontal lobe tumours receiving LVT .