Pharmacological and clinical aspects of antiepileptic drug use in the elderly

E. Perucca, D. Berlowitz, Angela K Birnbaum, James C Cloyd, J. Garrard, J. T. Hanlon, R. H. Levy, M. J. Pugh

Research output: Contribution to journalArticlepeer-review

129 Scopus citations

Abstract

In this article, epidemiological and clinical aspects related to the use of antiepileptic drugs (AEDs) in the elderly are highlighted. Studies have shown that people with epilepsy receiving AED treatment show important deficits in physical and social functioning compared with age-matched people without epilepsy. To what extent these deficits can be ascribed to epilepsy per se or to the consequences of AED treatment remains to be clarified. The importance of characterizing the effects of AEDs in an elderly population is highlighted by epidemiological surveys indicating that the prevalence of AED use is increased in elderly people, particularly in those living in nursing homes. Both the pharmacokinetics and the pharmacodynamics of AEDs may be altered in old age, which may contribute to the observation that AEDs are among the drug classes most commonly implicated as causing adverse drug reactions in an aged population. Age alone is one of several contributors to alterations in AED response in the elderly; other factors include physical frailty, co-morbidities, dietary influences, and drug interactions. Individualization of dosage, avoidance of unnecessary polypharmacy, and careful observation of clinical response are essential for an effective and safe utilization of AEDs in an elderly population.

Original languageEnglish (US)
Pages (from-to)49-63
Number of pages15
JournalEpilepsy Research
Volume68
Issue numberSUPPL. 1
DOIs
StatePublished - Jan 2006

Bibliographical note

Funding Information:
Dr. Garrard's research was supported by grants from the National Institute for Neurological Diseases and Stroke (P50-NS 16308) in support of the Epilepsy Clinical Research Program at the University of Minnesota. SF-36 ® is a registered trademark of the Medical Outcomes Trust.

Keywords

  • Antiepileptic drugs
  • Clinical pharmacology
  • Drug interactions
  • Elderly
  • Pharmacoepidemiology

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