“There has always been a question about whether it is worth using antiepileptic medications to protect against seizures in patients with a brain tumor even though we can’t predict who will actually have a seizure,” said lead review author Ivo Tremont-Lukats, M.D.
Tremont-Lukats is staff neurologist at the Culicchia Neurological Clinic in New Orleans and a clinical assistant professor of neurology at Louisiana State University.
The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
The review included five studies looking at outcomes in 404 patients with brain tumors but no previous history of seizures. Some received one of three common antiseizure drugs: phenytoin (Dilantin), phenobarbital or divalproex sodium (Depakote). Others patients received a placebo or underwent close observation. Researchers found no differences in preventing the first seizure among the three groups.
“The results are such that we really can’t recommend seizure prevention using these three older anticonvulsants,” Tremont-Lukats said. “There was not a protective effect seen when using these drugs.”
In addition, the risk of side effects — such as drowsiness, bruising and unusual bleeding — was much higher for those using the drugs.
This review looked only at older medications. Because of a lack of usable studies, the researchers could not assess if newer antiepileptic medications might be more useful in stopping first seizures.
“We need to look at the newer generation of anticonvulsants to see if they can protect against first seizures,” Tremont-Lukats said. “These drugs are more specific and have fewer side effects, but we still do not know scientifically if they have a protective effect.”
Tremont-Lukats stressed that this recommendation is only for those who do not have a history of having seizures. If someone has a seizure, then antiepileptic drugs are indicated.
“If a physician wants to put a patient on these medications for more than seven days after surgery, then there may be a problem that the patient should bring up with their doctor,” says Tremont-Lukats. “After a week, there is no evidence that they help and ample evidence of side effects.”
Omkar Markand, M.D., director of the Comprehensive Epilepsy Program at the Indiana University School of Medicine, said that automatically placing people with brain tumors on antiepileptic medications is a common occurrence despite there being no scientific proof that it is useful.
“There is good evidence that all three of the medications have side effects that need to be weighed against any possible benefits,” Markand said. “For those medications, the side effects are worse than any possible benefit. This research is another indication that patients should probably ask their neurosurgeon or other physician if it is really necessary to place them on antiepileptic medication prior to experiencing a seizure.”
Markand stressed that recommendations based on this review are only applicable to the older medications phenytoin, phenobarbital and divalproex sodium.
“The take-home message is that the patients should not accept an automatic placement on antiepileptic medications,” Markand said. “They should ask questions about why these drugs are being prescribed. The needs of the individual should be determined instead of putting everyone on antiepileptic medications.”
Lisa Esposito | EurekAlert!
Study suggests possible new target for treating and preventing Alzheimer's
02.12.2016 | Oregon Health & Science University
The first analysis of Ewing's sarcoma methyloma opens doors to new treatments
01.12.2016 | IDIBELL-Bellvitge Biomedical Research Institute
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water
In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...
The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.
Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
02.12.2016 | Medical Engineering
02.12.2016 | Agricultural and Forestry Science
02.12.2016 | Physics and Astronomy