Barbiturates and valproates in the pharmacotherapy of epilepsy: clinical and psychological interactions

Authors

Keywords:

barbiturates, epilepsy, pharmacotherapy, psychopharmacotherapy, valproates.

Abstract

This paper analyzes the indicators of somatization, obsessive-compulsive disorders, interpersonal sensitivity, anxiety, depression, phobic manifestations, paranoia, and psychoticism in the context of pharmacotherapy of epilepsy with barbiturates and valproates. Pharmacological therapy for epilepsy should rely on a rationally adjusted regimen with antiepileptic medicines being patient-tailored and targeted; it should have high efficiency and safety in relation to social functioning and quality of patients’ life. The research findings show that the studied group of patients with epilepsy, exposed to valproate or barbiturate therapy, is characterized by heterogeneous clinical-psychopathological and pathopsychological features. Clinico-psychopathologically, barbiturates reveal severe affective disorders and psychopathic behavior in patients with epilepsy; pathopsychological examination refers to the prominence of indicators on the scales of somatization, depression, and psychoticism, expressed in the form of somatic complaints, individual organs and systems’ disorders, and accompanied by mental equivalents, in particular on the side of the cardiovascular system, musculoskeletal system, gastrointestinal tract, etc.; depressive manifestations are also evident, reflecting the depth of affective disorders, dysphorias, suicidal tendencies, low mental activity with cognitive signs of depression, and the inclination to an avoidant, isolated lifestyle. Clinically, valproate therapy showed a predominantly neurotic character of mental changes; pathopsychological examination revealed the prevalence of obsessive-compulsive disorders, alternated with the anxiety, somatic and cognitive manifestations of anxiety.

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References

Agrawal, N. Treatment of psychoses in patients with epilepsy: an update / N. Agrawal, M. Mula // Therapeutic Advances in Psychopharmacology – 2019.

Amirkhanian M. G. Antiepileptic pharmacotherapy is the leading factor in the induced pathomorphosis of epilepsy / M. G. Amirkhanian // Epilepsy and paroxysmal conditions – 2018. – 10(2). – Рр. 59 – 73.

Azizova, R., Features of clinical course of epilepsy associated with anxiety and depressive disorders / R. Azizova, O. Umirkulov // European science review. – 2018. – № 9-10-2.

Bertrand de Toffol et al. Pharmacotherapy in patients with epilepsy and psychosis / Bertrand de Toffol [et al.] // Epilepsy & Behavior – 2018. – №8. – Pр. 54–60.

Birru, E. M. Drug therapy of epileptic seizures among adult epileptic outpatients of University of Gondar Referral and Teaching Hospital, Gondar, Northwest Ethiopia / E. M. Birru, M. Shafi, M. Geta // Neuropsychiatr Dis Treat. – 2016. – №12. – Рр. 3213–3219.

Byung, In Lee Clinical opinion: Earlier employment of polytherapy in sequential pharmacotherapy of epilepsy / Byung In Lee, Kang Min Park, Sung Eun Kim, Kyoung Heo // Epilepsy Research. – 2019. – Рр. 156.

Campos, M.S. Efficacy and Tolerability of Antiepileptic Drugs in Patients with Focal Epilepsy / M. S. Campos, L. R. Ayres, M. R. S. Morelo, F. A. Marques, L. R. L. Pereira // Systematic Review and Network Meta‐analyses. Pharmacotherapy. – 2016. – №36. – Рр. 1255–1271.

Landmark & Svein I Johannessen, C. J. Pharmacotherapy in epilepsy – does gender affect safety? / C. J. Landmark & Svein I Johannessen // Expert Opinion on Drug Safety. – 2016. – № 15:1. – Рр. 1-4.

Chaudhary, N. et al. Frequencies of CYP2C9 polymorphisms in North Indian population and their association with drug levels in children on phenytoin monotherapy / N. Chaudhary, M. Kabra, S. Gulati [et al.] // BMC Pediatrics. – 2016. – №16:66.

Derogatis, L. R. Neurotic symptom dimensions as perceived by psychiatrists and patients of various social classes / R. S. Lipman, L. Covi [et al.] // Arch. Gen. Psychiatr – 1971. – Vol. 24. – Р.454–464.

Derogatis, L.R. Confirmation of the dimensional structure of the SCL–90: a study in construct validation / L. R. Derogatis, P. A. Cleary // Clinical Psychol. –1977. – Vol. 33. – Р. 981–989.

Dzharashtieva, Dzan-Pago, Modern methods of pharmacotherapy of generalized forms of epilepsy / А. Bulgakova, Р. Shevchenko, S. Karpov, I. Vishlova // European science review. – 2017. – №3-4.

Farrokh, S. Use of Newer Anticonvulsants for the Treatment of Status Epilepticus / S. Farrokh, J. Bon, M. Erdman // Tesoro Pharmacotherapy – 2019. – 39. – Рр. 297-316.

Grynkiv, I. O. Cost analysis of epilepsy pharmacotherapy by valproic acid and carbamazepine / I. O. Grynkiv, O. B. Blavatska, O. M. Zaliska // Farmatsevtychnyi Zhurnal. 2018. – № 2. – Рр. 21-29.

Holtkamp, M. Pharmacotherapy for Refractory and Super-Refractory Status / M. Holtkamp // Epilepticus in Adults. Drugs 78. – 2018. – Рр. 307–326.

Milovanović, Jasmina R. et al. Evaluation of brivaracetam: a new drug to treat epilepsy / Milovanović, Jasmina R. [et al.] // Expert Opinion on Pharmacotherapy. – 2017. – 18:13, Рр. 1381-1389.

Jerry, J. Shih et al. Epilepsy treatment in adults and adolescents: Expert opinion / Jerry J. Shih [et al.] // Epilepsy & Behavior. – 2017. – № 69. – Pр. 186-222.

Juan, C. et al. Clinical guideline: antiepileptic drugs of choice for epileptic syndromes and epilepsies in pediatric patients / С. Juan [et al.] // Mex Neuroci. –2019. – 20(2), Рр. 89-96.

Kantae, V., Krekels, E. H. J., Esdonk, M. J. V. et al. Integration of pharmacometabolomics with pharmacokinetics and pharmacodynamics: towards personalized drug therapy / V. Kantae, E. H. J. Krekels, M. J. V. Esdonk, [et al.] // Metabolomics. – 2017. – 13(1), Р. 9.

Kopciuch, D., Barciszewska, A., Fliciński, J. et al. Analysis of pharmacotherapy regimen and costs in patients with drug-resistant epilepsy following vagus nerve stimulation therapy: a single-center study (Poland). / D. Kopciuch, A., Barciszewska, J. Fliciński [et al.] // Acta Neurol Belg. – 2020. – Рр. 120, 115–122.

Kumar, J. Sleep Related Epilepsy and Pharmacotherapy / J. Kumar, A. Solaiman, P. Mahakkanukrauh, R. Mohamed // An Insight. Front. Pharmacol. – 2018. – № 9. – Р. 1088.

Lang, T. A. Kak opisat' statistiku v meditsine. Annotirovannoye rukovodstvo dlya avtorov, redaktorov i retsenzentov [How to describe the statistics in medicine. An annotated guide to authors, editors and reviewers]. / T. A. Lang // Moscow: Practical medicine. – 2011.

Lance, W., Máire, O’Dwyer, Shankar, R. New anti-seizure medication for elderly epileptic patients / W. Lance, O’Dwyer Máire, R. Shankar // Expert Opinion on Pharmacotherapy. – 2019. – № 20:13, Р. 1601-1608.

Laurent, M. W., Bauer, S., Rosenow F., Strzelczyk, A. Recent advances in the pharmacotherapy of epilepsy: brivaracetam and perampanel as broad-spectrum antiseizure drugs for the treatment of epilepsies and status epilepticus/ М. W. Laurent, S. Bauer, F. Rosenow, А. Strzelczyk // Expert Opinion on Pharmacotherapy. – 2014. – Р. 1755-1765.

Li, H., Wang, B., Chang C., Wu M., Xu Y., Jiang Y. The Roles of Variants in Human Multidrug Resistance (MDR1) Gene and Their Haplotypes on Antiepileptic Drugs Response: A Meta-Analysis of 57 Studies. / H. Li, B. Wang, C. Chang, M. Wu, Xu Y., Y. Jiang // PLoS ONE.– 2015. – № 10(3).

Loughman, A., Bowden, S., D'Souza, W. Cognitive functioning in general idiopathic epilepsies: a systematic review and meta-analysis /A. Loughman, S. Bowden, W. D'Souza / Neuroscience. Biobehavior Review. – 2014. – № 43. Р. 20-34.

Nasledov, A. Matematicheskiye metody v psikhologicheskom issledovanii. Analiz I interpretatsiya dannykh. Rukovodstvo [Mathematical methods in a psychological research. Analysis and interpretation of data. Tutorial]. / A. Nasledov. – Saint Petersburg: Rech Publ. – 2014.

Pharmacological treatment of epilepsy // Epilepsy, NICE. – 2020. – Рр. 1-12.

Powell, G., Marson, A. Pharmacotherapy for Medication-Resistant Epilepsy. /In J. Stern, R. Sankar, M. Sperling (Eds.), // Medication-Resistant Epilepsy: Diagnosis and Treatment Cambridge: Cambridge University Press. – 2020. – Рp. 179-186.

Ramzi, S. et al. Pharmacists' knowledge of issues in pharmacotherapy of epilepsy using antiepileptic drugs / S. Ramzi [et al.] // A cross-sectional study in Palestinian pharmacy practice. – 2017. – P. 39-44.

Rupa, J. et al. Depression in patients receiving pharmacotherapy for epilepsy: An audit in a tertiary care center / J. Rupa [et al.] // Pharmacological Reports. – 2019. – P. 848-854

Schulze-Bonhage, A. A. Review of pharmacotherapy for treating focal epilepsy: where are we now and how will treatment develop? / Schulze-Bonhage, A. A. // Expert Opinion on Pharmacotherapy – 2017. – 18:17. – Рр. 1845-1853.

Shlomo Shinnar, M. D., et al. Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus / M. D. Shlomo Shinnar [et al.] // N Engl J Med. – 2019. – 381:2103-2113.

Tokareva, N.G., Zheleznova, E.V. Spetsifika lokusa kontrolya bol'nykh epilepsiyey [Specifics of locus of control in patients with epilepsy]. Vestnik Ural'skoy meditsinskoy akademicheskoy nauki. [Bulletin of the Ural Medical Academic Science]. –2014. – №3:49, Р.60-62.

Tokareva, N.G., Zheleznova, E.V. Kliniko-psikhologicheskaya otsenka emotsional'nykh rasstroystv u bol'nykh epilepsiyey [Clinico-psychological assessment of emotional disorders in patients with epilepsy]. Zhurnal nauchnykh rabot Zdorov'ye i obrazovaniye v XXI veke. [Journal of scientific papers Health and Education in the XXI century]. – 2016. – № 18:2. – Р. 214-216.

Tokareva, N.G., Zheleznova, E.V. Kliniko-psikhologicheskaya otsenka vnimaniya patsiyentov s epilepsiyey. [Clinico-psychological assessment of attention in patients with epilepsy]. Zhurnal nauchnykh rabot Zdorov'ye i obrazovaniye v XXI veke. [Journal of scientific papers Health and Education in the XXI century]. 2016. – №18: 1. – Р.28-30.

Tokareva, N.G., Zheleznova, E.V. Klinicheskaya otsenka spellinga u bol'nykh epilepsiyey [Clinical assessment of spelling in patients with epilepsy]. Zhurnal nauchnykh rabot Zdorov'ye i obrazovaniye v XXI veke. [Journal of scientific papers Health and Education in the XXI century]. – 2016. – № 18:1. – Р. 31-33.

Tokareva, N.G., Zheleznova, E.V. Kliniko-psikhologicheskaya otsenka aleksitimii u bol'nykh epilepsiyey podrostkovogo vozrasta [Clinico-psychological assessment of alexithymia in adolescent epilepsy patients]. Detskaya i podrostkova reabilitatsiya. [Childhood and teenage rehabilitation]. –2016. – №2:27. –Р.29-31.

Willems, L.M., Bauer, S., Jahnke, K. et al. Therapeutic Options for Patients with Refractory Status Epilepticus in Palliative Settings or with a Limitation of Life-Sustaining Therapies / L. M. Willems, S. Bauer, K. [et al.] // A Systematic Review. CNS Drugs. – 2020. – №34, Р. 801–826.

Zheleznova, E.V., Tokareva, N.G. Kliniko-psikhologicheskiye kharakteristiki rasstroystv funktsionirovaniya pri epilepsii [Clinico-psychological characteristics of the functioning disorders in epilepsy]. Rossiyskiy psikhiatricheskiy zhurnal. [Russian Psychiatric Journal]. – 2017. – №3. – Р.27-32.

Zeng, Q. Y, Fan, T. T., P. Zhu, et al. Comparative Long-Term Effectiveness of a Monotherapy with Five Antiepileptic Drugs for Focal Epilepsy in Adult Patients / Q. Y. Zeng, T. T. Fan, P. Zhu [et al.] // A Prospective Cohort Study. PLoS One. – 2015. – 6;10(7).

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Published

2023-04-14

How to Cite

Natalia Tokareva, Olga Ignatieva, & Irina Boinova. (2023). Barbiturates and valproates in the pharmacotherapy of epilepsy: clinical and psychological interactions . AVFT – Archivos Venezolanos De Farmacología Y Terapéutica, 40(8). Retrieved from http://caelum.ucv.ve/ojs/index.php/rev_aavft/article/view/26108