Abstract
Purpose: Anti-seizure medications (ASMs) are associated
with a variety of adverse events (AEs) that have a significant
detrimental impact on quality of life and treatment adherence. The aim
of the study was to identify and quantify the AEs of ASMs in persons
with epilepsy (PWE) using Liverpool Adverse Events Profile (LAEP), and
to determine the feasibility of LAEP for predicting depression in PWE.
Methods: After ethical clearance, 309 PWE above 18 years
of age, on ASMs, attending epilepsy clinic in neurology outpatient
department of All India Institute of Medical Sciences, New Delhi, India,
were recruited and evaluated for depression using different assessment
tools, and LAEP screening tool was used for adverse event profiling.
Results: The mean LAEP scores in PWE were 28.2±6.2 and
ranged from 19 to 49. Only 16 PWE had LAEP score ≥45 i.e. had high
toxicity. Phenytoin had the highest LEAP score, followed by
carbamazepine, levetiracetam, and sodium valproate. As compared to
monotherapy, PWE on polytherapy had higher LAEP score (26.7±5.9 vs.
29.03±6.3; p=0.0013). Subjects positive for depression had significantly
higher LAEP score than PWE without depression (33.5±6.2 vs. 24.7±3.1;
p<0.0001). A strong positive correlation of the LAEP score was
observed with depression scores as assessed by different assessment
tools, and a LAEP score of ≥28 was recommended to screen PWE for
depression.
Conclusion: The systematic use of LAEP in epilepsy
outpatient settings will allow for better detection and management of
ASM’s adverse effects, as well as the identification of PWE at risk of
depression.
Keywords: Persons with epilepsy (PWE), Depression, Liverpool
Adverse Events Profile (LAEP), Anti-seizure medications (ASMs), Adverse
events (AEs)