Comparison of tolerability and adverse symptoms in oxcarbazepine and carbamazepine in the treatment of trigeminal neuralgia and neuralgiform headaches using the Liverpool Adverse Events Profile (AEP)

The Journal of Headache and Pain

Research Article

D. R. Boniface¹  E. Besi²  J. M. Zakrzewska²  R. Cregg³ 

[1] Department of Epidemiology, UCL, Health Behaviour Research Centre, 1-19 Torrington Place, WC1E 6BT, London, UK;Facial Pain Unit, Eastman Dental Hospital, UCLH NHS Foundation Trust, 256 Gray′s Inn Road, WC1X 8LD, London, UK;Pain Management Centre National Hospital for Neurology and Neurosurgery, 1st Floor Queen Mary Wing, Queen Square, WC1N 3BG, London, UK;

关键词: Drug-related side effects and adverse reactions;    Carbamazepine;    Oxcarbazepine;    Trigeminal neuralgia;   

DOI  :  10.1186/s10194-015-0563-z

 received in 2015-06-17, accepted in 2015-08-11,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAdverse effects of drugs are poorly reported in the literature . The aim of this study was to examine the frequency of the adverse events of antiepileptic drugs (AEDs), in particular carbamazepine (CBZ) and oxcarbazepine (OXC) in patients with neuralgiform pain using the psychometrically tested Liverpool Adverse Events Profile (AEP) and provide clinicians with guidance as to when to change management.MethodsThe study was conducted as a clinical prospective observational exploratory survey of 161 patients with idiopathic trigeminal neuralgia and its variants of whom 79 were on montherapy who attended a specialist clinic in a London teaching hospital over a period of 2 years. At each consultation they completed the AEP questionnaire which provides scores of 19–76 with toxic levels being considered as scores >45.ResultsThe most common significant side effects were: tiredness 31.3 %, sleepiness 18.2 %, memory problems 22.7 %, disturbed sleep 14.1 %, difficulty concentrating and unsteadiness 11.6 %. Females reported significantly more side effects than males. Potential toxic dose for females is approximately 1200 mg of OXC and 800 mg of CBZ and1800mg of OXC and 1200 mg of CBZ for males.ConclusionsCBZ and OXC are associated with cognitive impairment. Pharmacokinetic and pharmacodynamic differences are likely to be the reason for gender differences in reporting side effects. Potentially, females need to be prescribed lower dosages in view of their tendency to reach toxic levels at lower dosages.Side effects associated with AED could be a major reason for changing drugs or to consider a referral for surgical management.

【 授权许可】

CC BY   
© Besi et al. 2015