Up to 30% of patients do not respond well to the anticonvulsants they try.

A recent report shows that people on a more aggressive treatment regimen, with three or more antiepileptic medications, have a three times lower risk of sudden death than people treated with one AED alone. Combinations including lamotrigine, valproic acid and levetiracetam were associated with reduced risk. Concurrent treatment with statins also reduced the risk of death, while antidepressants had no effect. While no one specific antiepileptic drug was associated with a higher risk than the others, poor adherence to treatment significantly raises the chance of seizure-related death. In general, the chance of side effects increases the more medications a person takes. Pharmacogenetic testing can be instrumental in guiding medication selection and tailoring medication dosage to reduce these risks and improve peace of mind with overall treatment.

First published September 23, 2020, DOI: https://doi.org/10.1212/WNL.0000000000010874

Pharmacogenetic testing informs epilepsy treatment

Pharmacogenetic tests can assess the metabolism of multiple medications used for epilepsy treatment. Personal Medicine Profile is a leading pharmacogenetic medication optimization service that includes a state-of-the-art pharmacogenetic test and a medication review by a clinical pharmacist. Personal Medicine Profile pharmacists will provide written recommendations for your doctor on safe AED drug selection and dosage ranges to help manage your epilepsy.

Summary

  • Epilepsy medication should be matched to epilepsy type and your genetic profile
  • Mismatched treatment can lead to undesired side effects and reduced compliance with treatment, which could be fatal
  • HLA genes determine the risk of SJS, severe AED-induced skin toxicity. Ask your doctor if you are in a high-risk category
  • Pharmacogenetic testing coupled with a pharmacist review of medications can provide insights into your metabolism of many drugs used for epilepsy treatment
  • Knowing your inherited drug metabolic profile can help your doctor select appropriate drug doses and reduce side effects.

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