The role of polytherapy in the management of epilepsy: suggestions for rational antiepileptic drug selection

被引：48

作者：

Verrotti, Alberto ^{[1
]}

Tambucci, Renato ^{[2
,3
]}

Di Francesco, Ludovica ^{[1
]}

Pavone, Piero ^{[4
]}

Iapadre, Giulia ^{[1
]}

Altobelli, Emma ^{[5
]}

Matricardi, Sara ^{[6
]}

Farello, Giovanni ^{[1
]}

Belcastro, Vincenzo ^{[7
]}

机构：

[1] Univ Aquila, Dept Pediat, Via Vetoio 1, Laquila, Italy

[2] Univ Aquila, Pediat Unit, Laquila, Italy

[3] IRCCS, Bambino Gesu Childrens Hosp, Digest Endoscopy & Surg Unit, Rome, Italy

[4] Univ Catania, Dept Pediat, Catania, Italy

[5] Univ Aquila, Dept Life Hlth & Environm Sci, Laquila, Italy

[6] Salesi Hosp Ancona, Dept Child Neuropsychiat, Ancona, Italy

[7] ASST LARIANA, Child Neuropsychiat Unit, Dept Mental Hlth, Como, Italy

来源：

EXPERT REVIEW OF NEUROTHERAPEUTICS | 2020年 / 20卷 / 02期

关键词：

Antiepileptic polytherapy; drug-resistant epilepsy; antiepileptic drugs combinations; synergism; pharmacokinetics; tolerability; COMBINATION THERAPY; REFRACTORY EPILEPSY; FOCAL EPILEPSY; VALPROIC ACID; EFFICACY; CARBAMAZEPINE; LAMOTRIGINE; SEIZURES; MECHANISMS; LACOSAMIDE;

D O I：

10.1080/14737175.2020.1707668

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Introduction: Antiepileptic polytherapy may be indicated in patients experiencing drug-resistant epilepsy. To date, there are no evidence-based criteria on how to combine different antiepileptic drugs (AEDs) together, in order to obtain the best therapeutic response. Areas covered: This paper reviews the available data about the various associations of AEDs in patients undergoing polytherapy, focusing on the most effective and well-tolerated polytherapies. Moreover, some controversial aspects of this topic are addressed. Expert opinion: Nowadays, there are no guidelines on polytherapy in patients with epilepsy; thus, the management of pharmacoresistant epilepsy is still uncertain, except for valproate/lamotrigine combination, which seems to be the only one recommended. Data regarding mechanism of action, pharmacokinetics, tolerability, and, more importantly, the analysis of the valuable clinical studies of drug combinations can help physicians to choose the best and most effective AED association for each patient.

引用

页码：167 / 173

页数：7

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