A prospective study of adverse drug reactions to antiepileptic drugs in children

BMJ Open. 2015 Jun 1;5(6):e008298. doi: 10.1136/bmjopen-2015-008298.

Abstract

Objectives: To prospectively determine the nature and rate of adverse drug reactions (ADRs) in children on antiepileptic drugs (AEDs) and to prospectively evaluate the effect of AEDs on behaviour.

Setting: A single centre prospective observational study.

Participants: Children (<18 years old) receiving one or more AEDs for epilepsy, at each clinically determined follow-up visit.

Primary and secondary outcomes: Primary outcome was adverse reactions of AEDs. Behavioural and cognitive functions were secondary outcomes.

Results: 180 children were recruited. Sodium valproate and carbamazepine were the most frequently used AEDs. A total of 114 ADRs were recorded in 56 of these children (31%). 135 children (75%) were on monotherapy. 27 of the 45 children (60%) on polytherapy had ADRs; while 29 (21%) of those on monotherapy had ADRs. The risk of ADRs was significantly lower in patients receiving monotherapy than polytherapy (RR: 0.61, 95% CI 0.47 to 0.79, p<0.0001). Behavioural problems and somnolence were the most common ADRs. 23 children had to discontinue their AED due to an ADR.

Conclusions: Behavioural problems and somnolence were the most common ADRs. Polytherapy significantly increases the likelihood of ADRs in children.

Trail registration number: EudraCT (2007-000565-37).

Keywords: CLINICAL PHARMACOLOGY.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Anticonvulsants / administration & dosage
  • Anticonvulsants / adverse effects*
  • Carbamazepine / administration & dosage
  • Carbamazepine / adverse effects*
  • Child
  • Child, Preschool
  • Cognition Disorders / chemically induced*
  • Drug Therapy, Combination / adverse effects*
  • Epilepsy / drug therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Lamotrigine
  • Male
  • Prospective Studies
  • Severity of Illness Index
  • Sleep Disorders, Intrinsic / etiology
  • Triazines / administration & dosage
  • Triazines / adverse effects*
  • United Kingdom / epidemiology
  • Valproic Acid / administration & dosage
  • Valproic Acid / adverse effects*

Substances

  • Anticonvulsants
  • Triazines
  • Carbamazepine
  • Valproic Acid
  • Lamotrigine

Associated data

  • EudraCT/2007-000565-37