Association between the use of classic vs new anti-seizure drugs and appearance of first episode of psychosis in patients with epilepsy: experience at the NINNN, Mexico
Abstract number :
1.417
Submission category :
7. Anti-seizure Medications / 7E. Other
Year :
2022
Submission ID :
2232927
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:28 AM
Authors :
Karen Edith Guzman Sanchez, MD – Centro Medico ABC; Artemio rosiles Abonce, MD – NINNN; Edgar Daniel Crail-Melendez, MD – NINNN; Juan Carlos Delgado-Uriarte, MD – Centro Medico 20 de noviembre ISSSTE; Iris Martínez-Juárez, MD – NINNN; Erik Rodrigo Velasquez Coria, MD – INCMNSZ
Rationale: Psychosis in epilepsy occurs seven times more frequently than primary schizophreniform disorders in the general population. The etiology of psychosis in epilepsy is multifactorial. One of the most important causes are medications. Observational studies have suggested that the so-called “classic” anti-seizure drugs (ASD) may increase the risk of postictal and interictal psychotic episodes. The main objective was to establish the association between the use of “new” versus “classic” ASD and the appearance of the first episode of interictal and postictal psychosis in patients with epilepsy.
Methods: Observational, cross-sectional, analytical and retrospective study in adult patients treated at the neuropsychiatry and epilepsy consultation of the NINN with a diagnosis of first episode of postictal or interictal psychosis. A non-probabilistic demonstration was performed at convenience. It was analyzed in SPSS V21
Results: A total of 302 patient records were reviewed, 158 of which met the inclusion criteria. About the use of ASD in 49 patients (30.8%), 63 (39.6%) in bitherapy, and 44 (27.7%) in polytherapy. Eighty (50.3%) used only classic drugs, 20 (12.6%) only new drugs, and 58 (36.5%) a combination of classic and new FACs. The mean of ASD used was 1.99 (range 0-4). The most used ASD was valproate in 58.8% (N=93) of the subjects, mean dose 1404 mg (range 200-3000 mg). Approximately half of the patients used classic ASD, the rest with new ASD or a combination of classic and new. It was found that the majority of patients with epilepsy and psychosis use classic ASD in mono or polytherapy. Predominant use of valproate
Conclusions: Due to the retrospective nature of the study, an association between the appearance of the first episode of psychosis and the use of classic ASD was not established. A multivariate analysis is required.
Funding: No funding was received.
Anti-seizure Medications