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05.02.2024 | Original Article

Overnight switch from carbamazepine to eslicarbazepine in a real-life clinical scenario: a retrospective study

verfasst von: Biagio Maria Sancetta, Lorenzo Ricci, Jacopo Lanzone, Marilisa Boscarino, Flavia Narducci, Giulia Lippa, Marianna Nesta, Vincenzo Di Lazzaro, Mario Tombini, Giovanni Assenza

Erschienen in: Neurological Sciences

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Abstract

Background

Carbamazepine (CBZ) is a first-choice anti-seizure medication (ASM) whose efficacy is often invalidated by adverse effects (AEs). Eslicarbazepine (ESL) is a structural derivative of CBZ with better pharmacokinetic/tolerability profiles. We describe our experience of the overnight CBZ to ESL switch in people with epilepsy (PwE) to improve seizure control, AEs, and ASMs adherence.

Methods

We retrospectively included 19 PwE (12 females, 53 ± 21 years old) who underwent CBZ to ESL overnight switch due to single/multiple issues: poor efficacy (pEff, N = 8, 42%), tolerability (pToll, N = 11, 58%), adherence (pAdh, N = 2, 10%). 9/19 (47%) had psychiatric comorbidities. Clinical variables, seizure frequency, and AEs were recorded at switch time (T0) after 3.5 ± 3 (T1) and 6.5 ± 1.5 months (T2).

Results

At T1, in pEff group, 1/8 (13%) was seizure free, 2/8 (25%) were responders (> 50% seizure reduction), 2/8 (25%) had no seizure changes, 3/8 (37%) had seizure worsening; the latter were those with the most severe epilepsy and encephalopathy. In pToll group, all PwE experienced AEs disappearance/amelioration. In pAdh group, all PwE reported adherence amelioration. Four dropouts. At T2, no changes were recorded within groups, while in the whole sample, 6/15 (40%) were responders, and 4/15 (27%) were seizure-free. No one complained of Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation psychiatric worsening, while 6/19 (32%) experienced mood/behavior benefits.

Conclusions

CBZ to ESL overnight switch offers an opportunity to improve efficacy, tolerability, adherence, and psychiatric symptoms.

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Titel: Overnight switch from carbamazepine to eslicarbazepine in a real-life clinical scenario: a retrospective study
verfasst von: Biagio Maria Sancetta
Lorenzo Ricci
Jacopo Lanzone
Marilisa Boscarino
Flavia Narducci
Giulia Lippa
Marianna Nesta
Vincenzo Di Lazzaro
Mario Tombini
Giovanni Assenza
Publikationsdatum: 05.02.2024
Verlag: Springer International Publishing
Erschienen in: Neurological Sciences
Print ISSN: 1590-1874
Elektronische ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-024-07354-6

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