Epilepsy

Question 1

Lamotrigine, perampanel, phenobarbital and phenytoin have long half lives, when can they be given?

Answer 1

OD at bedtime

Question 2

What are the recommendations if monotherapy of a first antiepileptic has failed?

Answer 2

Monotherapy with another epileptic

Question 3

How should you transition to a second epileptic?

Answer 3

slowly withdraw the first antiepileptic when the new regimen has been established

Question 4

List category 1 anti-epileptics and what is their significance?

Answer 4

phenytoin, phenobarbital, primidone, carbamezipine. Brand specific. CP3

Question 5

List category 2 anti-epileptics and what is their significance?

Answer 5

valproate, lamotrigine, perampanel, rufinamide, clobazam, clonazepam, oxcarbazapine, esclicarbazapine, zonisamide, topiramate. can be interchanged with caution under clinical judgement and consultation with patient.

Question 6

List category 3 anti-epileptics and what is their significance?

Answer 6

levetiracetam, lacosamide, tiagabine, gabapentin, pregabalin, ethosuximide, vigabatrin. usually unneccessary to ensure pts on specific manufacturers product.

Question 7

what risks do all antiepileptic drugs have in term of mental wellbeing?

Answer 7

small risk of suicidal thoughts. advised to seek medical attention if experience any mood changes, distressing thoughts or feelings about suicide.

Question 8

What are the driving requirements?

Answer 8

stop driving immediately and report to dvla, if first or unprovoked cannot drive for 6 months…….