抗癫痫药物与智障和癫痫老年人的挑战行为之间的关系:综述。

IF 3.4 2区 医学 Q2 CLINICAL NEUROLOGY Expert Review of Neurotherapeutics Pub Date : 2024-11-01 Epub Date: 2024-08-19 DOI:10.1080/14737175.2024.2393322
Seungyoun Moon, Lance Watkins, Maire O'Dwyer, Rohit Shankar
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引用次数: 0

摘要

导言:过度用药,特别是精神药物,包括抗癫痫药物(ASM),对智障人士的负面影响日益受到关注。这对老年人群尤为重要,因为在老年人群中,多重疾病和多种药物治疗更为常见。ASM 与精神和行为方面的不良反应有关。此外,人们越来越意识到抗胆碱能药物对患有癫痫和智障的老年人造成的负担以及与挑战行为(BtC)之间的关系:本综述对老年人群进行了定义,并概述了癫痫与智障之间的关系。在人口背景下概述了 BtC 以及与 ASM 的关系。还介绍了指导较新的 ASMs 处方和停药的证据基础,包括实用数据:多药治疗,尤其是精神药物,是患有癫痫和智障的老年人的一个死亡风险因素。因此,任何 BtC 都需要采用多学科方法进行整体评估。这包括在多药合用的背景下对所有处方药进行具体考虑。应当对 40 岁及以上的患者进行例行复查,至少每年一次,尤其要重点关注抗胆碱能药物负担和/或多重用药情况。
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Relationship between anti-seizure medication and behaviors that challenge in older persons with intellectual disability and epilepsy: a review.

Introduction: There is increased focus on the negative impact of the overprescribing of medication, specifically psychotropic medication, including anti-seizure medications (ASM), in people with Intellectual Disability (ID). This is particularly important for the older adult population, where multi-morbidity and polypharmacy are more common. ASMs are associated with psychiatric and behavioral adverse effects. Furthermore, there is growing awareness of the anticholinergic burden for older adults with epilepsy and ID and the relationship with behaviors that challenge (BtC).

Areas covered: This review defines the older adult population and outlines the relationship between epilepsy and ID. BtC is outlined in the context of the population and the relationship with ASMs. The evidence base to guide prescribing and de-prescribing for newer ASMs is also presented, including pragmatic data.

Expert opinion: Polypharmacy, particularly psychotropics, are a mortality risk factor for older adults with epilepsy and ID. Therefore, any BtC requires a holistic assessment with a multi-disciplinary approach. This includes specific consideration of all prescribed medicines in the context of polypharmacy. There should be routine reviews, at least annually, for those aged 40 years and over particularly focused on anticholinergic burden and/or polypharmacy.

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来源期刊
Expert Review of Neurotherapeutics
Expert Review of Neurotherapeutics Medicine-Neurology (clinical)
CiteScore
7.00
自引率
2.30%
发文量
61
审稿时长
4-8 weeks
期刊介绍: Expert Review of Neurotherapeutics (ISSN 1473-7175) provides expert reviews on the use of drugs and medicines in clinical neurology and neuropsychiatry. Coverage includes disease management, new medicines and drugs in neurology, therapeutic indications, diagnostics, medical treatment guidelines and neurological diseases such as stroke, epilepsy, Alzheimer''s and Parkinson''s. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points
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