Adjunctive antiepileptic drug treatment can lower risk of dying from a sudden unexpected death
New research published Online First in The Lancet Neurology, has found that epilepsy patients who receive additional treatment with antiepileptic drugs (AEDs) have about a seven times lower risk of dying from a sudden unexpected deaththe most common cause of death in epilepsy patients.
Sudden unexplained death is 20 times more common in people with epilepsy than in the general population. Research has identified some potentially preventable risk factors for sudden unexpected death in epilepsy (SUDEP) including a high number of generalised tonic-clonic seizures (the most common type of generalised seizure that affects the entire brain) and taking a combined regimen of AEDs (polytherapy). But until now, no intervention has been assessed in a controlled study or shown a beneficial effect at preventing SUDEP.
In this study, Philippe Ryvlin, Hôpital Neurologique, Lyon, France, and colleagues pooled data from 112 randomised trials of AED add-on treatment of adults with refractory (treatment-resistant) epilepsy to compare the incidence of definite and probable SUDEP between patients receiving adjunctive AED therapy at effective doses and those given placebo.
A total of 33 deaths occurred in the trials, of which 18 deaths were deemed probable or definite SUDEP, and two deaths possible SUDEP.
Overall, analyses showed that patients treated with adjunctive AEDs at effective doses were about seven times less likely to die of a SUDEP than patients given placebo.
Rates of definite and probable SUDEP were 0.9 per 1000 person-years in the AED group and 6.9 per 1000 person-years in the placebo group.
The authors suggest that the treatment-related reduction in seizure frequency is the most likely explanation for the very low rate of SUDEP in patients given AEDs at effective doses.
They point out that contrary to research suggesting that polytherapy might increase the risk of SUDEP: "Our data suggest that add-on AEDs at doses effective on seizure frequency reduce the risk of SUDEP despite increasing the drug load, at least during the average 3-month duration of randomised trials."
They conclude: "This finding provides an argument not only for active revision and optimum management of treatment in patients with uncontrolled seizures, but also for further prospective and long-term investigation of this unsettled issue."
In a Comment, Dale Hesdorffer from Columbia University, New York, USA and Torbjorn Tomson from the Karolinska Institute, Stockholm, Sweden, outline three key implications of the findings: "First, the study provides strong evidence for an effective intervention to reduce SUDEP risk
Second, the protective effective of adjunctive therapy suggests that seizure control could be extremely important for SUDEP prevention
Third, polytherapy does not increase risk of SUDEP during the time period of a randomised trial."
More information: Paper online: www.thelancet.com/… 3-4/abstract
Provided by Lancet
- Drops in blood oxygen levels may be key to sudden death in some epilepsy patients Nov 17, 2008 | not rated yet | 0
- Adjunctive rufinamide reduces refractory partial-onset seizures Oct 01, 2010 | not rated yet | 0
- Gene identified for sudden unexpected death in epilepsy Apr 13, 2010 | not rated yet | 0
- Heart link discovered in sudden epilepsy deaths Nov 08, 2010 | not rated yet | 0
- Adverse drug effects in epileptic patients not correlated with number of prescribed medications Apr 20, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
How can there be villous adenoma in colon, if there are no villi there
11 hours ago As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
- More from Physics Forums - Medical Sciences
More news stories
(HealthDay)—Migraines and depression can each cause a great deal of suffering, but new research indicates the combination of the two may be linked to something else entirely—a smaller brain.
Neuroscience 2 hours ago | 5 / 5 (1) | 0 |
Moving objects attract greater attention – a fact exploited by video screens in public spaces and animated advertising banners on the Internet. For most animal species, moving objects also play a major ...
Neuroscience 5 hours ago | not rated yet | 0 |
It is known that signs of neurological disorders such as Alzheimer's and Huntington's disease can appear years before the disease becomes manifest; these signs take the form of subtle changes in the brain and behavior of ...
Neuroscience 5 hours ago | not rated yet | 0
Scientists have reversed behavioral and brain abnormalities in adult mice that resemble some features of schizophrenia by restoring normal expression to a suspect gene that is over-expressed in humans with ...
Neuroscience 7 hours ago | 5 / 5 (1) | 0 |
Researchers at Johns Hopkins have unraveled the molecular foundations of cocaine's effects on the brain, and identified a compound that blocks cravings for the drug in cocaine-addicted mice. The compound, already proven safe ...
Neuroscience 7 hours ago | not rated yet | 0 |
(HealthDay)—For HIV-infected individuals with recurrent Clostridium difficile infection, fecal microbiota therapy is feasible, according to a letter published in the May 21 issue of the Annals of Intern ...
1 hour ago | not rated yet | 0
Calorie information in fast food restaurants used by 40 percent of 9-18 year olds when making food choices
A new study published online today (Thursday) in the Journal of Public Health has found that of young people who visited fast food or chain restaurants in the U.S. in 2010, girls and youth who were obese were more likely ...
5 minutes ago | not rated yet | 0
An independent panel of experts on Wednesday recommended US approval of a new Merck sleeping pill called suvorexant, but expressed concerns over the highest dosage and risks of drowsy daytime driving.
1 hour ago | not rated yet | 0
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
3 hours ago | not rated yet | 2 |
Swiss scientists reveal the mechanism responsible for aging hidden deep within mitochondria—and dramatically slow it down in worms by administering antibiotics to the young.
6 hours ago | 4.5 / 5 (2) | 0 |
(HealthDay)—Implementation of systematic monitoring for medication adherence will allow for identification of barriers to adherence and tailoring of interventions, according to a viewpoint piece published ...
1 hour ago | not rated yet | 0