Adverse effect profiling of persons with epilepsy in a tertiary care
centre using LAEP scale: Correlation with co-morbid depression.
Abstract
Purpose: Anti-seizure medications (ASMs) are associated with a variety
of adverse events (AEs) that have a significant detrimental impact on
quality of life and treatment adherence. The aim of the study was to
identify and quantify the AEs of ASMs in persons with epilepsy (PWE)
using Liverpool Adverse Events Profile (LAEP), and to determine the
feasibility of LAEP for predicting depression in PWE. Methods: After
ethical clearance, 309 PWE above 18 years of age, on ASMs, attending
epilepsy clinic in neurology outpatient department of All India
Institute of Medical Sciences, New Delhi, India, were recruited and
evaluated for depression using different assessment tools, and LAEP
screening tool was used for adverse event profiling. Results: The mean
LAEP scores in PWE were 28.2±6.2 and ranged from 19 to 49. Only 16 PWE
had LAEP score ≥45 i.e. had high toxicity. Phenytoin had the highest
LEAP score, followed by carbamazepine, levetiracetam, and sodium
valproate. As compared to monotherapy, PWE on polytherapy had higher
LAEP score (26.7±5.9 vs. 29.03±6.3; p=0.0013). Subjects positive for
depression had significantly higher LAEP score than PWE without
depression (33.5±6.2 vs. 24.7±3.1; p<0.0001). A strong
positive correlation of the LAEP score was observed with depression
scores as assessed by different assessment tools, and a LAEP score of
≥28 was recommended to screen PWE for depression. Conclusion: The
systematic use of LAEP in epilepsy outpatient settings will allow for
better detection and management of ASM’s adverse effects, as well as the
identification of PWE at risk of depression.