RESUMO
Complementary and alternative medicines (CAMs) are increasingly used by patients in the Western world. Some of the most popular herbal remedies are known to act on the cytochrome P450 system, with potential effects on antiepileptic drug (AED) levels. Few studies have explored their use in people with epilepsy. We surveyed 400 patients attending epilepsy clinics in Greater Manchester. Thirty-four percent of our patients had used or were using CAMs; the majority had not told their doctor. Use of CAMs was not predicted by age, sex, seizure frequency, number of AEDs, or dissatisfaction with conventional medicine. Patients who had gone onto higher education were significantly (P < 0.05) more likely to have used or be using CAMs. The majority of patients did not use CAMs for their epilepsy but for general health purposes. Most patients stated that CAMs had little or no effect on seizure frequency or severity.
Assuntos
Terapias Complementares/estatística & dados numéricos , Uso de Medicamentos/estatística & dados numéricos , Epilepsia/terapia , Pesquisas sobre Atenção à Saúde , Adulto , Anticonvulsivantes/uso terapêutico , Atitude Frente a Saúde , Estudos de Coortes , Terapias Complementares/métodos , Escolaridade , Epilepsia/epidemiologia , Feminino , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de SaúdeRESUMO
After reports of reversible parkinsonism and cognitive impairment with sodium valproate (VPA), the authors examined 50 consecutive patients taking VPA and 20 patients taking carbamazepine. Three patients taking VPA exhibited unequivocal parkinsonism with Unified Parkinson Disease Rating Scale scores >30. VPA was withdrawn from two patients with improvement of symptoms. Reduction in VPA dosage in the third patient produced no improvement. beta-CIT-SPECT scans were normal, suggesting dopaminergic neuronal loss is not the underlying mechanism.
