Other AED drugs

Question 1

Gabapentin - safety information

Answer 1

Levels of propylene glycol, acesulfame K and saccharin
sodium may exceed the recommended WHO daily
intake limits if high doses of gabapentin oral solution
(Rosemont brand) are given to adolescents or adults
with low body-weight (39–50 kg).

Question 2

Lamotrigine - blood disorders

Answer 2

Rarely associated with aplastic anaemia, bone-marrow depression and pancytopenia
Symptoms of BMF:
- anaemia
- bruising
- infection

Question 3

Lamotrigine - skin reactions

Answer 3

Steven-Johnson’s syndrome and toxic necrolysis can develop within first 8 weeks.
Rash is sometimes associated with hypersensitivity syndrome. Consider withdrawal if rash or signs of AHS develop.

Question 4

Lamotrigine - facts associated with increased risk of skin reactions

Answer 4

• Concommitant use of valproate
• Initial lamotrigine dosing higher than recommmended.
• More rapid dose escalation than recommended.

Question 5

Topiramate

Answer 5

Acute myopia (short-sightedness) with secondary angle-closure glaucoma.
Typically occurs within 1 month of starting treatment.
Fluid build-up resulting in anterior displacement of the lens and iris has also been reported.

Question 6

Topiramate - raise intraocular pressure

Answer 6

• Seek specialist ophthalmological advice.
• Appropriate measures to reduce intra-ocular pressure.
• Stop topiramate as rapidly as feasible.

Question 7

Vigabatrin

Answer 7

Visual field defects.
Occurs 1 month - years after starting.
Problems persists despite discontinuation.
Visual field testing before treatment and every 6 months.
Any new visual symptoms that develop should be reported and reviewed urgently.
Consider gradual withdrawal of vigabatrin.

Question 8

Benzodiazepines

Answer 8

Should only be administered by or under direct supervision of an experienced personnel with adequate training in anaesthesia and airway management.