Management of Adverse Effects in Patients on Antiepileptic Medications

Identifying and Managing Adverse Effects

• The American Academy of Emergency Medicine recommends checking if symptoms interfere with activities of daily living or pose injury risk, as part of assessing severity and safety risk in patients with gait abnormalities 1
• The American Academy of Emergency Medicine suggests that evaluating fall risk immediately and screening for suicidal ideation or severe behavioral changes are crucial steps in managing patients on antiepileptic medications like levetiracetam and perampanel, as both medications carry warnings for psychiatric symptoms 1
• Maintaining the current dose of levetiracetam (1500 mg/day) is recommended initially, as it provides seizure control and the dose is within the therapeutic range, according to Praxis Medical Insights 2

Medication Adjustment and Monitoring

• The American Academy of Emergency Medicine advises against abruptly discontinuing either levetiracetam or perampanel without a taper plan, as this risks breakthrough seizures in patients with structural epilepsy, and recommends reassessing seizure control if the patient has been seizure-free for an extended period 1