Epilepsy drugs for children

The medical community believes that a different drug development program for children is necessary as the progression of epilepsy and response to treatment are not the same in adults and children. Early in 2008 the U.S. Food and Drug Administration (FDA) warned doctors that drugs used to treat epilepsy (also called antiepileptic drugs or AEDs) may have serious side effects.

Why should I be aware of this?

As many medicines are not fully tested on children before licensing, doctors and consultants have no official guidance on doses to refer to when prescribing. They have to rely on estimations to prescribe a safe and effective dose based on the age and the size of the child.

How does this affect me?

Treatment of epilepsy among children got a boost with Keppra, a drug, specifically tailored for children as young as six months. Developed by Belgian drug-maker UCB Pharmaceuticals, it has been approved for use among children by the US Food and Drugs Administration. This will possibly eliminate the need for trial and error dosages based on a consultant’s experience.

All about epilepsy drugs for children

Control of epilepsy seizure is clearly important and, in most children, is probably the key factor in determining their quality of life. But this should not be at the expense of the child's general health and ability to function. Though a large number of new anti-epileptic drugs have been introduced, none of these drugs have yet replaced the older drugs, specifically sodium valproate and carbamazepine.

On the contrary, addition of these new drugs has paradoxically contributed to a therapeutic confusion which often leads to inappropriate treatment of some of the pediatric epilepsies. Hence, there remains a clear need to undertake robust but pragmatic clinical trials of any novel and emerging anti-epileptic drugs in children.

Side effects

Concerns over pediatric drugs have risen in recent years after some of them were found to cause visual field defects, ranging from asymptomatic to severe and potentially disabling.

The American Food and Drug Administration and the National Institutes of Health have been leading the process for pediatric drug reform over the last ten years. And the European Union has proposed the Better Medicines for Children regulation and devised a research strategy to improve pediatric medicines research in the hope of increasing the availability of licensed medicines for children.

New vs. old drugs

With traditional antiepileptic drugs there have been long-standing concerns about their neurobehavioral effects as well as effects on various organ systems such as the liver and blood-forming organs.

Infants and children are more susceptible than adults to toxic reactions that can affect their health, including negative effects on body weight, insulin sensitivity, lipid profile, and bone density. Certain AEDs have been found to cause obesity and higher insulin levels.

The older enzyme-inducing AEDs, including phenytoin and primidone as well as phenobarbital and carbamazepine, have been associated with lower bone mineral density. Systematic study of newer AEDs on bone mineral density is lacking, though it is reported that new-generation AEDs appear to be either weight-neutral or to cause potentially beneficial weight loss.

What can I do?

• Learn when and how to give the drugs to the child, its side effects, and what to do and who to call in case of a severe reaction.
• Follow the prescription and make sure your child takes the right medicine, in the right dosage, at the right time.
• Be aware about what to do if the child misses a dose.
• Stopping medication suddenly can trigger life-threatening seizures. Get any change of dosage first approved by your child's doctor.
• Make sure you never run out of medication.
• Don't give any other drugs unless they're approved by your child's doctor. They may react adversely with the prescribed AEDs.
• Don't give your child any alcohol.
• Carry enough medication while traveling.
• Store medication at the right temperature, as specified by your pharmacist, and out of reach of children.

CopperBytes

• Antiepileptic drugs do not cure epilepsy, but rather attempt to control or prevent seizures. Strictly speaking, these medications are antiseizure or anticonvulsant, rather than antiepileptic.
• Antiepileptic medications do not actually affect the underlying problem predisposing to seizures. People with epilepsy are prescribed antiepileptic medications with the aim of decreasing the number, severity, and/or duration of seizures.
• While seizure freedom is the ideal outcome of treatment, seizures can still occur while taking antiepileptic medication.
• Antiepileptic medication is usually prescribed for children with recurrent seizures, ideally after a specific epilepsy syndrome diagnosis is made and the risk of subsequent seizures is known. However, there are instances when a doctor may prescribe medication after a single
• Other factors taken into consideration when prescribing antiepileptic medication include the child's age, other medical conditions, findings on an EEG, other medications the child is taking, and potential for side effects.

References:

• Drug to treat epileptic children on the anvil
• Fears over child epilepsy drugs
• Bio-Medicine
• AboutKidsHealth