John Libbey Eurotext

Recommendations for treatment strategies in people with epilepsy during times of shortage of antiseizure medications Volume 24, numéro 5, October 2022

Auteurs
for the ILAE Emergency Task Force
1 Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA, USA
2 Boston Children’s Hospital, Harvard Medical School. Department of Neurology, Division of Epilepsy & Clinical Neurophysiology, Boston, MA, USA
3 Department of Neurology, Christian-Doppler Medical Centre, Paracelsus Medical University, Centre for Cognitive Neuroscience Salzburg, Member of the European Reference Network, EpiCARE, Salzburg, Austria; Department of Public Health, Health Services Research and Health Technology Assessment, UMIT – University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria; Karl-Landsteiner Institute for Neurorehabilitation and Space Neurology, Salzburg, Austria; Neuroscience Institute, Christian-Doppler Medical Centre, Paracelsus Medical University, Centre for Cognitive Neuroscience Salzburg, Austria
4 Department of Developmental Neurology, Chair of Neurology, Medical University of Gdańsk, Poland
5 UCL NIHR BRC Great Ormond St Institute of Child Health, Great Ormond Street Hospital for Children, London & Young Epilepsy, UK
6 Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Drake University, Des Moines, Iowa, USA
This report was written by experts selected by the International League Against Epilepsy (ILAE) and was approved for publication by the ILAE. Opinions expressed by the authors, however, do not necessarily represent the policy or position of the ILAE
Correspondence:
Ali A. Asadi-Pooya
Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

In times of severe antiseizure medication (ASM) shortage due to emergency situations (e.g., disasters, conflicts, sudden disruption to international supply chains), management of people with epilepsy with available ASMs can be difficult. A group of experts was brought together by the International League Against Epilepsy (ILAE) to formulate recommendations for such circumstances. Every effort was made to base these recommendations on direct published literature or extrapolations from basic information available about ASMs. Actual published literature in this area is, however, limited, and at times, assumptions were made by the experts to generate these recommendations. During times of shortage of ASMs, switching between different ASMs (e.g., oxcarbazepine and carbamazepine) can occasionally be considered as a mitigation procedure. However, for many ASMs, the option of an overnight switch to another drug does not exist. Switching from brand to generic or between generic products has often been shown to be safe, if required. Finally, when supplies of benzodiazepines or equipment to administer medications intravenously are not available, rectal administration of some ASMs may be an emergency alternative route for treating serial seizures and status epilepticus. Decision-making with regard to treatment and possible options should be driven by what is best for the patient.

ILAE Academy

Licence Cette œuvre est mise à disposition selon les termes de la Licence Creative Commons Attribution - ShareAlike 3.0 International