Influence of Antiepileptic Medications on Seizure Frequency in Insomnia: Milena Pavlova, MD

WATCH TIME: 2 minutes

“Most antiepileptic medications are sedating. That is one of the other challenges that can sometimes be limited for the patient and can lead to various kinds of considerations for when they are taking the medications.”

One of the currently available antiseizures medications, lamotrigine (Lamictal; GlaxoSmithKline), has been known to control many types of seizures and is considered the least sedative for patients. Despite the drug’s impact on seizure control, it has been shown to be associated with insomnia risk.²

Prior research from Mark Quigg, MD, and colleagues reported that presence of insomnia is associated with short-term poor seizure control and worse quality of life in patients with epilepsy.¹ In the study, 207 patients completed surveys, of which 43% reported having clinically significant insomnia, 51% had at least mild insomnia and 58% were seizure free. Other factors associated with more severe insomnia included younger age, shorter duration of epilepsy, use of sedative/hypnotics, medical and sleep comorbidities, delayed sleep timing and chronotype, excessive sleepiness, and depression.

At the 2022 American Epilepsy Society Annual Meeting, held December 2 to 6, in Nashville, Tennessee, Milena Pavlova, MD, sat down in an interview with NeurologyLive^® to discuss the associations between seizure frequency and sleep health in relation to Quigg’s study. Pavlova, associate professor at Harvard Medical School and neurologist at the Brigham and Women's Hospital, also provided insight on antiepileptic drugs such as lamotrigine, and to the available information on efficacy of controlling seizures and the secondary effect of improving sleep.

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REFERENCES
 1. Quigg M, Gharai S, Ruland J, et al. Insomnia in epilepsy is associated with continuing seizures and worse quality of life. Epilepsy Res. 2016;122:91-96. doi:10.1016/j.eplepsyres.2016.02.014
2. Liguori C, Toledo M, Kothare S. Effects of anti-seizure medications on sleep architecture and daytime sleepiness in patients with epilepsy: A literature review. Sleep Med Rev. 2021;60:101559. doi:10.1016/j.smrv.2021.101559