A review on antiepileptic drugs-dependent fatigue: Pathophysiological mechanisms and incidence

作者：Siniscalchi Antonio; Gallelli Luca; Russo Emilio^*; De Sarro Giovambattista

来源：European Journal of Pharmacology, 2013, 718(1-3): 10-16.

DOI：10.1016/j.ejphar.2013.09.013

• AED
• Side effect
• Fatigue
• Central mechanism
• Peripheral mechanism

Fatigue represents a common side effect of several drugs, however, the underlying mechanisms have not been well identified. A depression of the central nervous system (CNS) and/or changes in peripheral processes have been associated with the development of fatigue. Antiepileptic drugs (AEDs), generally decreasing CNS excitability, are used in the treatment of seizures as well as other neurological and psychiatric diseases. Fatigue is certainly a common AEDs side effect, although a high degree of variability exists depending on both patients' characteristics and the drug used. Here, we delineate the pathophysiological central and peripheral mechanisms by which AEDs may cause fatigue also reviewing the available clinical data in order to assess a possible AEDs rank and highlight each AEDs related risk it appears that drugs acting on the GABAergic system have the highest incidence (with tiagabine exception) of fatigue followed by Gabapentin and Levetiracetam whereas drugs mainly inhibiting sodium channels (Carbamazepine, Eslicarbazepine, Lamotrigine, Phenytoin and Valproate) have the lowest. However, the dose used, AEDs related side effects and patients' characteristics might influence the degree of fatigue observed.

• 出版日期2013-10-15