Management of epilepsy in the elderly
Juan José PozaDepartment of Neurology, Hospital Donostia, San Sebastián, SpainAbstract: Epilepsy among the elderly is a frequently occurring pathology, differing in etiology, clinical presentation and prognosis from those of young people. In addition, beyond a certain a...
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Dove Medical Press
2007
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oai:doaj.org-article:0e4f555478ed4e05b461d44890fa30d32021-12-02T04:33:42ZManagement of epilepsy in the elderly1176-63281178-2021https://doaj.org/article/0e4f555478ed4e05b461d44890fa30d32007-01-01T00:00:00Zhttp://www.dovepress.com/management-of-epilepsy-in-the-elderly-a952https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Juan José PozaDepartment of Neurology, Hospital Donostia, San Sebastián, SpainAbstract: Epilepsy among the elderly is a frequently occurring pathology, differing in etiology, clinical presentation and prognosis from those of young people. In addition, beyond a certain age, physiological modifications are produced in the metabolism which alter the pharmacokinetics of antiepileptic drugs (AEDs), increasing the risk of pharmacological interactions, already greater in these patients due to the frequency of poly-pharmacy. Furthermore, elderly patients are particularly sensitive to certain secondary effects of AEDs, as for example, cognitive disturbances, osteoporosis or weight increase. Given that the efficacy of the major AEDs is a priori quite similar, and that the epilepsies occurring in this age-group generally have a good prognosis, the selection of an AED will depend more upon its pharmacokinetics and ability to induce certain secondary effects than on its efficacy. In this respect, levetiracetam and pregabalin, followed by oxcarbazepine and lamotrigine have the most favorable pharmocokinetical profile. Moreover, on the whole these drugs have very few cognitive effects, do not induce osteoporosis and, with the exception of pregabalin, do not affect weight, making them the first selection for use in the treatment of epilepsy in the elderly.Keywords: epilepsy, the elderly, antiepileptic drugs Juan José PozaDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2007, Iss Issue 6, Pp 723-728 (2007) |
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DOAJ |
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Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 |
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Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Juan José Poza Management of epilepsy in the elderly |
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Juan José PozaDepartment of Neurology, Hospital Donostia, San Sebastián, SpainAbstract: Epilepsy among the elderly is a frequently occurring pathology, differing in etiology, clinical presentation and prognosis from those of young people. In addition, beyond a certain age, physiological modifications are produced in the metabolism which alter the pharmacokinetics of antiepileptic drugs (AEDs), increasing the risk of pharmacological interactions, already greater in these patients due to the frequency of poly-pharmacy. Furthermore, elderly patients are particularly sensitive to certain secondary effects of AEDs, as for example, cognitive disturbances, osteoporosis or weight increase. Given that the efficacy of the major AEDs is a priori quite similar, and that the epilepsies occurring in this age-group generally have a good prognosis, the selection of an AED will depend more upon its pharmacokinetics and ability to induce certain secondary effects than on its efficacy. In this respect, levetiracetam and pregabalin, followed by oxcarbazepine and lamotrigine have the most favorable pharmocokinetical profile. Moreover, on the whole these drugs have very few cognitive effects, do not induce osteoporosis and, with the exception of pregabalin, do not affect weight, making them the first selection for use in the treatment of epilepsy in the elderly.Keywords: epilepsy, the elderly, antiepileptic drugs |
| format |
article |
| author |
Juan José Poza |
| author_facet |
Juan José Poza |
| author_sort |
Juan José Poza |
| title |
Management of epilepsy in the elderly |
| title_short |
Management of epilepsy in the elderly |
| title_full |
Management of epilepsy in the elderly |
| title_fullStr |
Management of epilepsy in the elderly |
| title_full_unstemmed |
Management of epilepsy in the elderly |
| title_sort |
management of epilepsy in the elderly |
| publisher |
Dove Medical Press |
| publishDate |
2007 |
| url |
https://doaj.org/article/0e4f555478ed4e05b461d44890fa30d3 |
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AT juanjosampeacutepoza managementofepilepsyintheelderly |
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