Balanced Seizure Prevention: Individualized Epilepsy Treatment via In-Office Compounding Kits
Epilepsy is the most common serious neurological condition, and results in considerable morbidity.1 For many epilepsy patients who have achieved seizure prevention with anti-epilepsy drugs (AEDs), suppressing the uncontrollable electrical activity in the brain that had kept them from enjoying life also means suppressing themselves biophysically in some new, unexpected ways…which may or may not keep them from enjoying life, or even result in morbidity.
AED Side Effects — More Morbid than Epilepsy?
It is a well-known fact that AEDs come with some of the most debilitating side-effects on the pharmaceutical market.2 AEDs often weaken the memory, to the point that “slurred speech” and “mental confusion” are cited as some of the most common side effects.3 AEDs can also render decreased levels of overall physical strength and energy, resulting in “clumsiness” and “problems with walking or movement.” Emotionally, AEDs are still known to incur potentially lethal side effects: aggression, anger, depression, and suicidal thoughts and behavior are frequently found on warnings labels.4
For several epilepsy patients, reclaiming the ability to maintain one’s consciousness represents a major breakthrough in life. Simple, everyday tasks that were previously out of reach due to seizure activity, such as driving oneself to work, can be made possible again with the seizure prevention achieved through AEDs. That said, when taking AEDs means trading seizures in exchange for difficulty walking, mental confusion, and/or the emergence of suicidal behavior, the simple, everyday task of working itself — let alone driving oneself there — may very well become out of reach.
One Size Does Not Fit All
AEDs are potent medications. Therefore, it can be a particularly tedious task to find just the right balance of strength that is needed to prevent seizures, and of gentleness that is needed to avoid the onset of serious side effects. The fact that AEDs are typically prescribed in dosages that are not customized to individual patients, but rather are one-size-fits-all standards accepted throughout the medical community, can make it all the more difficult to find optimal dosages.
The standard initial dosages of two anticonvulsants commonly prescribed for adult epilepsy patients are 400 mg/day (Carbatrol) and 1000 mg/day (Keppra).5 The lowest dosage that a Keppra tablet even comes in is 250 mg.6 Needless to say, this doesn’t work well for every single patient.
Sundry Benefits of Customization via Compounding Kits
Prescription compounding is a rapidly growing part of physicians’ practices, but some may still not realize the extent of the resurgence that compounding has seen in recent years, due to today’s climate of aggressive marketing by drug manufacturers. Through the triad relationship of patient, pharmacist, and physician, all three can together solve unique medical problems.
The ability to adjust the strength of a medication is not the only benefit offered by in-office pharmacy compounding. With knowledge of the effects of inactive ingredients becoming more and more widespread, an increasing number of patients seek to avoid such unwanted ingredients within their pharmaceuticals, such as lactose, sugar, preservatives, and dyes.7 Flavors can be added to make medications more palatable to children, who may otherwise resist taking their medications. Compounding kits also allow pharmaceuticals to be administered via unique delivery systems — for patients who have difficulty swallowing a capsule, alternate forms of medication include topical gels or creams that can be absorbed through the skin.
Pharmaceutica North America offers Active Prep Kits featuring anticonvulsants Gabapentin and Phenytoin Sodium, both of which are indicated as therapies for seizure prevention. Gabapentin is also mass-marketed as AED Neurontin, but Neurontin film-coated scored tablets only come in dosages as low as 600 mg, which some patients find themselves breaking into halves to try and achieve their optimal dosages.8 Phenytoin Sodium is also marketed as AED Dilantin, and is often administered to adult epilepsy patients who have had no previous treatment at an initial dosage of 300 mg/ day. Needless to say — and yet here I am reiterating the point, as the issue merits considerable attention! — this also doesn’t work for every patient.9 Communication between pharmacists, physicians, and patients is crucial in determining a treatment plan that best suits the needs of the patient.
With Pharmaceutica North America’s Custom Compounding Kits, you can find the optimal dosage that is just right for each specific epilepsy patient. With PNA’s outstanding record for sterility and the ability to customize medications for individual patients that Active Prep Kits offer, what reason is there not to use PNA in-office pharmaceutical compounding kits? Please contact us today to learn more about our products.
- “Epilepsy,” 2009-2015, http://www.ucb-usa.com/Patients/conditions/cns/epilepsy ↩
- “The cognitive impact of antiepileptic drugs,” November 2011, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229254/ ↩
- “Past, Present, and Future in the Search for the Perfect Anti-epileptic Drug,” April 2002, http://dash.harvard.edu/bitstream/handle/1/8965599/Robinson.html?sequence=2 ↩
- “Keppra Side Effects,” “Carbatrol Side Effects,” “Dilantin Side Effects,” 2000-2015, http://www.drugs.com/sfx/keppra-side-effects.html, http://www.drugs.com/sfx/carbatrol-side-effects.html, http://www.drugs.com/sfx/dilantin-side-effects.html ↩
- Drugs.com. “Keppra Overview.” “Carbatrol Dosage.” Drugs.com, 2000-2015. <http://www.drugs.com/keppra.html><http://www.drugs.com/dosage/carbatrol.html> ↩
- “Keppra Drug Description,” 2015, http://www.rxlist.com/keppra-drug.htm ↩
- “‘Inactive’ Ingredients in Pharmaceutical Products: Update,” 2013 http://pediatrics.aappublications.org/content/99/2/268.full ↩
- “Neurontin: Professional,” 2000-2015, http://www.drugs.com/monograph/neurontin.html ↩
- “Dilantin Overview,” 2000-2015, http://www.drugs.com/dilantin.html ↩