New Guidelines Issued for Combining HIV, Seizure Meds

Doctors urged to use caution in treating HIV/AIDS patients who experience seizures

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_120425.html
(*this news item will not be available after 04/03/2012)

By Alan Mozes

Wednesday, January 4, 2012

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WEDNESDAY, Jan. 4 (HealthDay News) -- Physicians need to take care when prescribing seizure medication to HIV/AIDS patients to prevent harmful interactions between drugs, experts warn.
The cautionary note from the American Academy of Neurology (AAN) has led to the issuance of a new AAN guideline, which was developed in consultation with the International League Against Epilepsy.
"It is important that patients know exactly which drugs they are taking and provide that information to all prescribing health care providers caring for them," lead guideline author Dr. Gretchen L. Birbeck, of Michigan State University in East Lansing, said in an AAN news release.
"Doctors may need to watch and adjust drug doses in people with HIV/AIDS who take seizure drugs," added Birbeck, who is also an AAN fellow.
Seizures and related disorders are not uncommon among HIV patients, according to Birbeck and colleagues. It is estimated that at least 10 percent of HIV patients experience seizures, they noted.
In the new guideline, which is published in the Jan. 4 online editions of both Neurology and Epilepsia, the research team cautioned that effectiveness of either set of drugs can be compromised when specific seizure medications are taken alongside certain HIV/AIDS treatments. Increased toxicity is another potential issue.
For example, levels of certain seizure medications -- such as phenytoin, phenobarbital and carbamazepine -- actually drop off when they come in contact with seizure drugs. The risk: an HIV drug regimen might fail, the authors pointed out.
One way Birbeck's team hopes to mitigate against such risk is to outline the correct dosages of seizure drugs. They noted that dangerous drug interactions may be avoidable if medications are prescribed in the right amounts.
The team also acknowledged that the threat of harmful drug interactions is highest where drug choices are the most curtailed. That means that patients in poorer countries, where most HIV/AIDS patients now live, are particularly vulnerable to this dynamic.
"Future research should target epilepsy and HIV/AIDS drug combinations where choices are limited, such as in developing countries, to better understand the risk of these drug interactions," Birbeck said in the news release.

SOURCE: American Academy of Neurology, news release, Jan. 4, 2012

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