Abstract
Seizure disorders may complicate HIV disease, either as a direct result of HIV or as a manifestation of a secondary opportunistic infection. Unless a reversible cause of seizure activity can be discerned, current treatment guidelines recommend the use of anticonvulsant drugs in these patients. The concurrent use of antiretrovirals and anticonvulsants is a poorly studied area. Controlled clinical trials examining drug-drug and drug-disease interactions in this area are scant, leaving clinicians a therapeutic dilemma in terms of drug selection. Most studies have been retrospective in nature. Generalized seizures appear to be most common and occur most frequently in patients with more severe disease as indicated by lower mean CD4 + cell counts. In short follow-up periods, seizures appear to recur relatively frequently. Treatment of seizures in this population is hindered by a lack of clear data and numerous reports of drug-drug and drug-disease interactions. In order to best provide evidence-based care, controlled clinical trials are needed to discern which anticonvulsants are best suited for use in this population. Trials should also examine appropriate dose adjustments that may be warranted when anticonvulsants and antiretrovirals agents are used concurrently. Unless an identifiable and reversible cause of seizures is identified in this patient population seizures should be treated with standard therapy and close follow-up and monitoring. Newer anticonvulsants (i.e., gabapentin, tiagabine) with fewer drug interactions may be better alternatives when compared to older anticonvulsant agents. Clinicians might avoid valproic acid given some conflicting reports regarding potential for increasing viral replication.
Keywords: antiretrovirals, anticonvulsants, seizure disorders, generalized seizures
Current Pharmaceutical Design
Title: Concurrent Use of Antiretrovirals and Anticonvulsants in Human Immunodeficiency Virus (HIV) Seropositive Patients
Volume: 9 Issue: 18
Author(s): Frank Romanelli and Claire Pomeroy
Affiliation:
Keywords: antiretrovirals, anticonvulsants, seizure disorders, generalized seizures
Abstract: Seizure disorders may complicate HIV disease, either as a direct result of HIV or as a manifestation of a secondary opportunistic infection. Unless a reversible cause of seizure activity can be discerned, current treatment guidelines recommend the use of anticonvulsant drugs in these patients. The concurrent use of antiretrovirals and anticonvulsants is a poorly studied area. Controlled clinical trials examining drug-drug and drug-disease interactions in this area are scant, leaving clinicians a therapeutic dilemma in terms of drug selection. Most studies have been retrospective in nature. Generalized seizures appear to be most common and occur most frequently in patients with more severe disease as indicated by lower mean CD4 + cell counts. In short follow-up periods, seizures appear to recur relatively frequently. Treatment of seizures in this population is hindered by a lack of clear data and numerous reports of drug-drug and drug-disease interactions. In order to best provide evidence-based care, controlled clinical trials are needed to discern which anticonvulsants are best suited for use in this population. Trials should also examine appropriate dose adjustments that may be warranted when anticonvulsants and antiretrovirals agents are used concurrently. Unless an identifiable and reversible cause of seizures is identified in this patient population seizures should be treated with standard therapy and close follow-up and monitoring. Newer anticonvulsants (i.e., gabapentin, tiagabine) with fewer drug interactions may be better alternatives when compared to older anticonvulsant agents. Clinicians might avoid valproic acid given some conflicting reports regarding potential for increasing viral replication.
Export Options
About this article
Cite this article as:
Romanelli Frank and Pomeroy Claire, Concurrent Use of Antiretrovirals and Anticonvulsants in Human Immunodeficiency Virus (HIV) Seropositive Patients, Current Pharmaceutical Design 2003; 9 (18) . https://dx.doi.org/10.2174/1381612033454676
DOI https://dx.doi.org/10.2174/1381612033454676 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Strategy for a Genetic Assessment of Antipsychotic and Antidepressant- Related Proarrhythmia
Current Medicinal Chemistry Neonatal Atlas Templates for the Study of Brain Development Using Magnetic Resonance Images
Current Medical Imaging The Role of Folate-supplementation in Depression: A Narrative Review
Current Psychopharmacology The Role of Orexin System in Antipsychotics Induced Weight Gain
Current Psychiatry Reviews Synthesis and Anticonvulsant Activity Evaluation of 6-phenyl-7H-[1,2,4]triazolo[3,4-b][1,3,4]thiadiazines
Letters in Drug Design & Discovery Evolution of the Human Ion Channel Set
Combinatorial Chemistry & High Throughput Screening Toxins Targeting Voltage-Activated Ca<sup>2+</sup> Channels and their Potential Biomedical Applications
Current Topics in Medicinal Chemistry Role of the Transglutaminase Enzymes in the Nervous System and their Possible Involvement in Neurodegenerative Diseases
Current Medicinal Chemistry Mitochondrial Tolerance to Drugs and Toxic Agents in Ageing and Disease
Current Drug Targets β -Amyloid: A Disease Target or a Synaptic Regulator Affecting Age-Related Neurotransmitter Changes?
Current Pharmaceutical Design The Combination of rTMS and Pharmacotherapy on In Vitro Models: A Mini-Review
CNS & Neurological Disorders - Drug Targets Investigating Mitochondrial Dysfunction to Increase Drug Safety in the Pharmaceutical Industry
Current Drug Targets HPTLC Analysis with the Effect of <i>Bacopa monnieri, Evolvulus alsinoides</i> and <i>Tinospora cordifolia</i> against Scopolamine-Induced Amnesic Rats
Drug Delivery Letters Mitochondrial Biogenesis: A Therapeutic Target for Neurodevelopmental Disorders and Neurodegenerative Diseases
Current Pharmaceutical Design Antiepileptic Drugs in Clinical Development: Differentiate or Die?
Current Pharmaceutical Design A Compendium of Volatile Organic Compounds (VOCs) Released By Human Cell Lines
Current Medicinal Chemistry Phenylbutyric Acid Protects Against Spatial Memory Deficits in a Model of Repeated Electroconvulsive Therapy
Current Neurovascular Research Recent Inventions in Powder Technology and Granular Science Incorporating Improved Drug Delivery
Recent Patents on Engineering Editorial [Is Suicidality Serious?]
Current Drug Safety Critical Role of the Endocannabinoid System in the Regulation of Food Intake and Energy Metabolism, with Phylogenetic, Developmental, and Pathophysiological Implications
Endocrine, Metabolic & Immune Disorders - Drug Targets