Antiepileptic drug interactions in the elderly

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Abstract
Antiepileptic drugs (AEDs) are frequently prescribed in the elderly due to the high prevalence of AED-treatable neuropsychiatric disorders in this age group. There are several factors associated with AED therapy in the elderly that substantially increase the risk of clinically significant drug interactions. The elderly exhibit altered pharmacodynamics resulting in greater sensitivity to both pharmacological and toxicological drug effects. The use of polypharmacotherapy leaves the elderly patient at an increased risk for adverse events. There are no known drug interactions between anticoagulants/antiplatelets and the following AEDs: gabapentin (GBP), lamotrigine (LTG), levetiracetam (LEV), tiagabine (TGB), or zonisamide (ZNS). A number of AEDs either induce or inhibit drug metabolizing enzymes and, in turn, their metabolism is affected by many co-medications. Several of the newer AEDs do not appear to interact with other medications, while others are affected by enzyme induction of inhibition but do not appear to alter the disposition of co-medications.

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