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Antiepileptic Drugs
Combination Therapy and Interactions
This book reviews the use of antiepileptic drugs focussing on the interactions between these
drugs, and between antiepileptics and other drugs. These interactions can be beneficial or can
cause harm. The aim of this book is to increase awareness of the possible impact of combination
pharmacotherapies. Pharmacokinetic and pharmacodynamic interactions are discussed sup-
ported by clinical and experimental data. The book consists of five parts covering the general
concepts and advantages of combination therapies, the principles of drug interactions, the
mechanisms of interactions, drug interactions in specific populations or in patients with co-mor-
bid health conditions, concluding with a look at the future directions for this field of research.
The book will be of interest to all who prescribe antiepileptics to epileptic and non-epileptic
patients, including epileptologists, neurologists, neuropediatricians, psychiatrists and general
practitioners.
Antiepileptic Drugs
Combination Therapy and Interactions
Edited by
Jerzy Majkowski
The Foundation of Epileptology, Warsaw
Blaise F. D. Bourgeois
Harvard Medical School, USA
Philip N. Patsalos
Institute of Neurology, UK
and
Richard H. Mattson
Yale University School of Medicine, USA
cambridge university press
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo
Cambridge University Press
The Edinburgh Building, Cambridge cb2 2ru, UK
First published in print format
isbn-13
978-0-521-82219-0
isbn-13
978-0-511-12593-5
© Cambridge University Press 2005
2005
Information on this title: www.cambridge.org/9780521822190
This publication is in copyright. Subject to statutory exception and to the provision of
relevant collective licensing agreements, no reproduction of any part may take place
without the written permission of Cambridge University Press.
isbn-10
0-511-12593-3
isbn-10
0-521-82219-x
Cambridge University Press has no responsibility for the persistence or accuracy of urls
for external or third-party internet websites referred to in this publication, and does not
guarantee that any content on such websites is, or will remain, accurate or appropriate.
Published in the United States of America by Cambridge University Press, New York
www.cambridge.org
hardback
eBook (NetLibrary)
eBook (NetLibrary)
hardback
Contents
List of contributors
Page
ix
Foreword Giuliano Avanzini
xiii
Foreword Torbjörn Tomson
xv
Acknowledgements
xvii
Part I
Introduction
1
1
Combination therapy of diseases: general concepts
3
Emma Mason and Philip A. Routledge
2
Combination therapy with antiepileptic drugs: potential
advantages and problems
16
Richard H. Mattson
3
Pharmacogenetic aspects
26
Matthew C. Walker, Michael R. Johnson and Philip N. Patsalos
Part II
Pharmacokinetic interactions
45
4
Pharmacokinetic principles and mechanisms of drug interactions
47
Philip N. Patsalos
5
Predictability of metabolic antiepileptic drug interactions
57
Edoardo Spina, Emilio Perucca and Rene Levy
6
Influence of food and drugs on the bioavailability of antiepileptic drugs
93
Carlos A. Fontes Ribeiro
7
Interactions between antiepileptic drugs
111
Bernhard Rambeck and Theodor W. May
8
Interactions between antiepileptic and non-antiepileptic drugs
139
Jerzy Majkowski and Philip N. Patsalos
v
Part III
Pharmacodynamic interactions
179
9
Pharmacodynamic principles and mechanisms of drug interactions
181
Blaise F. D. Bourgeois
10
Methods for assessing pharmacodynamic interactions
193
Blaise F. D. Bourgeois
11
Experimental studies of pharmacodynamic interactions
208
Stanislaw J. Czuczwar
12
Clinical studies of pharmacodynamic interactions
228
John R. Pollard and Jacqueline French
13
Clinical studies of pharmacodynamic interactions
between antiepileptic drugs and other drugs
241
Gaetano Zaccara, Andrea Messori and Massimo Cincotta
Part IV
Drug interactions in specific patient populations
and special conditions
255
14
Antiepileptic drug interactions in children
257
Olivier Dulac, Elizabeth Rey and Catherine Chiron
15
Antiepileptic drug interactions in the elderly
273
Jeannine M. Conway and James C. Cloyd
16
Antiepileptic drug interactions in pregnancy
294
Mark S. Yerby
17
Antiepileptic drug interactions in handicapped and
mentally retarded patients
325
Matti Sillanpää
18
Antiepileptic drugs and sex steroids
341
Richard H. Mattson
19
Antiepileptic drug interactions in patients requiring
psychiatric drug treatment
350
Michael R. Trimble and Marco Mula
20
Antiepileptic drugs in non-epileptic health conditions:
possible interactions
369
Jerzy Majkowski
21
Drug monitoring in combination therapy
392
Walter Fröscher
vi
Contents
22
Cognitive side-effects due to antiepileptic drug
combinations and interactions
403
Albert P. Aldenkamp, Mark de Krom, Irene Kotsopoulos and Jan Vermeulen
Part V
Conclusions and future perspectives
419
23
Selection of drug combinations in clinical practice:
current and future perspectives
421
Jerzy Majkowski
24
Future research: an experimental perspective
441
Rob A. Voskuyl, Daniel M. Jonker and Fernando H. Lopes da Silva
25
Future research: a clinical prospective
458
Carlos A. Fontes Ribeiro
Index
475
vii
Contents
List of contributors
Professor Albert P. Aldencamp
Department of Neurology, University
Hospital of Maastricht, PO Box 21, NL 2100
AB, Heeze, The Netherlands
Professor Blaise F. D. Bourgeois
Children’s Hospital – HU2, Harvard Medical
School, 300 Longwood Avenue, Boston,
MA 02115, USA
Dr Catherine Chiron
Hospital Necker-Enfants Malades, 149 Rue
de Sevres, Paris 75015, France
Dr Massimo Cincotta
Unit of Neurology, Santa Maria Nuova
Hospital, Florence, Italy
Dr James C. Cloyd
College of Pharmacy, University of
Minnesota, Room 7101, Weaver Densford
Hall, 308 Harvard St SE, Minneapolis,
MN 55455 0353, USA
Dr Jeannine M. Conway
College of Pharmacy, University of
Minnesota, 7-170 WDH, 308 Harvard St SE,
Minneapolis, MN 55455, USA
Professor Stanislaw J. Czuczwar
Department of Pathophysiology, Medical
Academy, Jaczewskiego 8, 820-090 Lublin,
Poland
Dr Mark de Krom
Department of Neurology, University
Hospital of Maastricht, PO Box 21, NL 2100
AB, Heeze, The Netherlands
Professor Olivier Dulac
Hospital Necker-Enfants Malades, 149 Rue
de Sevres, Paris 75015, France
Professor Carlos A. Fontes Ribeiro
Department of Pharmacology,
Faculty of Medicine, 3000 Coimbra,
Portugal
Professor Jacqueline French
Department of Neurology, 3 West Gates,
Hospital of the University of Pennsylvania,
3400 Spruce St, PA 19104, USA
Professor Walter Fröscher
Department of Neurology and Epileptology,
Die Weissenau (Department of Psychiatry I),
University of Ulm, D-88214 Ravensburg,
Germany
Dr Michael R. Johnson
Division of Neurosciences and Psychological
Medicine, Imperial College London,
Charing Cross Hospital, London,
W6 8RP, UK
Dr Daniel M. Jonker
Epilepsy Institute of the Netherlands (SEIN),
Achterweg 5, NL 21 03 SW,
Heemstede, The Netherlands
ix