Exit Strategy: Balancing the Risks and Rewards of Antiseizure Medication Withdrawal

IF 5.8 2区 医学 Q1 CLINICAL NEUROLOGY
Marian Galovic, Carolina Ferreira-Atuesta, Lara E. Jehi, Kees P. J. Braun, Samuel W. Terman
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引用次数: 0

Abstract

The majority of people with epilepsy achieves long-term seizure-freedom and may consider withdrawal of their anti-seizure medications (ASMs). Withdrawal of ASMs can yield substantial benefits but may be associated with potential risks. This review critically examines the existing literature on ASM withdrawal, emphasizing evidence-based recommendations, where available. Our focus encompasses deprescribing strategies for individuals who have attained seizure freedom through medical treatment, those who have undergone successful epilepsy surgery, and individuals initiated on ASMs following acute symptomatic seizures. We explore state-of-the-art prognostic models in these scenarios that could guide the decision-making process. The review underscores the importance of a collaborative shared-decision approach between patients, caregivers, and physicians. We describe the subjective and objective factors influencing these decisions and illustrate how trade-offs may be effectively managed in practice.
退出策略:平衡停用抗癫痫药物的风险与回报
大多数癫痫患者在长期摆脱癫痫发作后可能会考虑停用抗癫痫药物(ASMs)。停用抗癫痫药物可带来巨大益处,但也可能存在潜在风险。本综述对有关 ASM 停药的现有文献进行了严格审查,并强调了以证据为基础的建议(如有)。我们关注的重点包括通过药物治疗获得癫痫发作自由的患者、成功接受癫痫手术的患者以及在急性症状性癫痫发作后开始使用 ASMs 的患者的停药策略。我们探讨了这些情况下可指导决策过程的最新预后模型。综述强调了患者、护理人员和医生之间合作共享决策方法的重要性。我们描述了影响这些决策的主观和客观因素,并说明了如何在实践中有效地权衡利弊。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Epilepsy Currents
Epilepsy Currents CLINICAL NEUROLOGY-
CiteScore
2.40
自引率
5.60%
发文量
88
审稿时长
>12 weeks
期刊介绍: Epilepsy Currents is an open access, bi-monthly current-awareness journal providing reviews, commentaries and abstracts from the world’s literature on the research and treatment of epilepsy. Epilepsy Currents surveys and comments on all important research and developments in a format that is easy to read and reference. Each issue is divided into two main sections: Basic Science and Clinical Science. An outstanding Editorial Board reviews the literature and assigns topics and articles to world experts for comment. In addition, the Editors commission authoritative review articles on important subjects.
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