文献詳細
文献概要
特集 脳神経外科医が知っておきたい—てんかんのすべて Ⅳ 脳神経外科医が知っておきたいてんかん治療
抗てんかん薬治療の基本
著者: 花谷亮典1
所属機関: 1鹿児島大学大学院医歯学総合研究科脳神経外科学
ページ範囲:P.95 - P.104
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・適切な薬物治療によって60〜70%の患者で発作が消失する.
・抗てんかん薬の服用はしばしば長期に及ぶため,発作型だけではなく,副作用を含めた各薬剤の特性と患者のライフサイクルを念頭に置いた薬剤選択を行う.
・新規抗てんかん薬は,従来薬に比べて薬物相互作用や長期内服に伴う副作用が軽減している.
・適切な薬物治療によって60〜70%の患者で発作が消失する.
・抗てんかん薬の服用はしばしば長期に及ぶため,発作型だけではなく,副作用を含めた各薬剤の特性と患者のライフサイクルを念頭に置いた薬剤選択を行う.
・新規抗てんかん薬は,従来薬に比べて薬物相互作用や長期内服に伴う副作用が軽減している.
参考文献
1)Kwan P, Brodie MJ:Early identification of refractory epilepsy. N Engl J Med 342:314-319, 2000
2)Perucca E, et al:Which terms should be used to describe medications used in the treatment of epilepsy? An ILAE position paper. https://www.ilae.org/files/dmfile/terms-to-describe-medications-used-in-the-treatment-of-epilepsy---draft.pdf(2022年11月7日アクセス)
3)Fisher RS, et al:ILAE official report:a practical clinical definition of epilepsy. Epilepsia 55:475-482, 2014
4)Kirmani BF, et al:Selection of antiepileptic drugs in older people. Curr Treat Options Neurol 16:295, 2014 doi:10.1007/s11940-014-0295-4
5)D'Souza W, et al;PERMIT study group:Perampanel for the treatment of patients with myoclonic seizures in clinical practice:evidence from the PERMIT study. Seizure 100:56-66, 2022
6)Hakami T:Neuropharmacology of antiseizure drugs. Neuropsychopharmacol Rep 41:336-351, 2021
7)Hanaya R, Arita K:The new antiepileptic drugs:their neuropharmacology and clinical indications. Neurol Med Chir(Tokyo)56:205-220, 2016
8)Operto FF, et al:Perampanel and childhood absence epilepsy:a real life experience. Front Neurol 13:952900, 2022 doi:10.3389/fneur.2022.952900
9)Temizyürek A, et al:Blood-brain barrier targeted delivery of lacosamide-conjugated gold nanoparticles:improving outcomes in absence seizures. Epilepsy Res 184:106939, 2022 doi:10.1016/j.eplepsyres.2022.106939
10)日本神経学会(監),「てんかん診療ガイドライン」作成委員会(編):てんかん診療ガイドライン2018.医学書院,東京,2018
11)Shih JJ, et al:Epilepsy treatment in adults and adolescents:expert opinion, 2016. Epilepsy Behav 69:186-222, 2017
12)Reimers A:New antiepileptic drugs and women. Seizure 23:585-591, 2014
13)Margolis JM, et al:Effectiveness of antiepileptic drug combination therapy for partial-onset seizures based on mechanisms of action. JAMA Neurol 71:985-993, 2014
14)French JA, Faught E:Rational polytherapy. Epilepsia 50(Suppl 8):63-68, 2009
15)Tanaka A, et al:Clinical characteristics and treatment responses in new-onset epilepsy in the elderly. Seizure 22:772-775, 2013
16)Ishizaki T, et al:Drug prescription patterns and factors associated with polypharmacy in > 1 million older adults in Tokyo. Geriatr Gerontol Int 20:304-311, 2020
17)Greenblatt DJ:Reduced serum albumin concentration in the elderly:a report from the Boston Collaborative Drug Surveillance Program. J Am Geriatr Soc 27:20-22, 1979
18)Schmidt D:Drug treatment of epilepsy:options and limitations. Epilepsy Behav 15:56-65, 2009
19)Josephson CB, et al:Association of enzyme-inducing antiseizure drug use with long-term cardiovascular disease. JAMA Neurol 78:1367-1374, 2021
20)Nordqvist O, et al:A novel index to assess low energy fracture risks in patients prescribed antiepileptic drugs. PLoS ONE 16:e0256093, 2021 doi:10.1371/journal.pone.0256093
21)Arif H, et al:Patient-reported cognitive side effects of antiepileptic drugs:predictors and comparison of all commonly used antiepileptic drugs. Epilepsy Behav 14:202-209, 2009
22)Kawada K, et al:Association of aggression and antiepileptic drugs:analysis using the Japanese adverse drug event report(JADER)database. Biol Pharm Bull 45:720-723, 2022
23)Wieshmann UC, Baker GA:Self-reported feelings of anger and aggression towards others in patients on levetiracetam:data from the UK antiepileptic drug register. BMJ Open 3:e002564, 2013 doi:10.1136/bmjopen-2013-002564
24)Reynolds EH, Green R:Valproate and folate:congenital and developmental risks. Epilepsy Behav 108:107068, 2020 doi:10.1016/j.yebeh.2020.107068
25)Meador KJ, et al;NEAD Study Group:Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years(NEAD study):a prospective observational study. Lancet Neurol 12:244-252, 2013
26)Tomson T, et al:Valproate in the treatment of epilepsy in girls and women of childbearing potential. Epilepsia 56:1006-1019, 2015
27)National Health Service UK:Epilepsy and pregnancy. https://www.nhs.uk/pregnancy/related-conditions/existing-health-conditions/epilepsy(2022年11月7日アクセス)
28)Vegrim HM, et al:Cancer risk in children of mothers with epilepsy and high-dose folic acid use during pregnancy. JAMA Neurol 79:1-10, 2022 doi:10.1001/jamaneurol.2022.2977
29)Burakgazi E, et al:The effect of pregnancy on seizure control and antiepileptic drugs in women with epilepsy. Rev Neurol Dis 8:16-22, 2011
30)Varelas PN, Jones M:Antiepileptic drugs in the neurosurgical intensive care. Curr Pharm Des 23:6533-6550, 2017
31)Stepień K, et al:Profile of anticonvulsant activity and neuroprotective effects of novel and potential antiepileptic drugs--an update. Pharmacol Rep 57:719-733, 2005
32)van Tuijl JH, et al:Early treatment after stroke for the prevention of late epileptic seizures:a report on the problems performing a randomised placebo-controlled double-blind trial aimed at anti-epileptogenesis. Seizure 20:285-291, 2011
33)Liu J, Wang LN:Gamma aminobutyric acid(GABA)receptor agonists for acute stroke. Cochrane Database Syst Rev 8:CD009622, 2014 doi:10.1002/14651858.CD009622.pub3
34)Kapoor R, et al:Lamotrigine for neuroprotection in secondary progressive multiple sclerosis:a randomised, double-blind, placebo-controlled, parallel-group trial. Lancet Neurol 9:681-688, 2010
35)Gloss D, et al;AAN Guideline Subcommittee:Antiseizure medication withdrawal in seizure-free patients:practice advisory update summary:report of the AAN Guideline Subcommittee. Neurology 97:1072-1081, 2021
36)Berg AT, Shinnar S:Relapse following discontinuation of antiepileptic drugs:a meta-analysis. Neurology 44:601-608, 1994
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