the art of managing conversions between antiepileptic drugs maximizing patient tolerability and quality of life抗癫痫药物之间的艺术管理转换最大化病人耐受性和生活质量.pdfVIP

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the art of managing conversions between antiepileptic drugs maximizing patient tolerability and quality of life抗癫痫药物之间的艺术管理转换最大化病人耐受性和生活质量.pdf

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the art of managing conversions between antiepileptic drugs maximizing patient tolerability and quality of life抗癫痫药物之间的艺术管理转换最大化病人耐受性和生活质量

Pharmaceuticals 2010, 3, 2956-2969; doi:10.3390/ph3092956 OPEN ACCESS pharmaceuticals ISSN 1424-8247 /journal/pharmaceuticals Review The Art of Managing Conversions between Antiepileptic Drugs: Maximizing Patient Tolerability and Quality of Life Erik K. St. Louis Department of Neurology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA; E-Mail: StLouis.Erik@; Tel.: +1-507-538-1038; Fax: +1-507-284-4074 Received: 29 July 2010; in revised form: 12 August 2010 / Accepted: 2 September 2010 / Published: 6 September 2010 Abstract: Conversion between anti-epilectic drugs (AEDs) is frequently necessary in epilepsy care, exposing patients to a risk of incurring adverse effects and reduced quality of life. Little practical guidance is available to practitioners to guide conversions between AED monotherapies, or in adding a new adjunctive AED into a polytherapy regimen. This article reviews the impact of adverse effects of AEDs on quality of life in epilepsy patients, then reviews several important patient-related factors such as age, gender, medical and psychiatric co-morbidities, and co-medications that must be considered when selecting AEDs and ensuring tolerable and safe AED conversions. Practical strategies for transitional polytherapy AED conversion are then considered in different commonly encountered clinical scenarios in newly diagnosed and refractory epilepsy care, including inadequate seiz