Strategies for Optimizing Antiepileptic Drug Therapy in Elderly People

Thomas E. Lackner, Pharm.D., FASCP


Pharmacotherapy. 2002;22(3) 

In This Article


Variable physiologic changes, increased risk for drug-drug interactions, and comorbid diseases in elderly patients unpredictably alter AED response. Consequently, it is particularly important to select an AED based on individual patient conditions and the drug's pharmacologic profile. Therapy is generally complicated by limited reliable dosage guidelines, especially for individuals more than 75 years of age. Lower starting dosages and more gradual dosage escalation than in younger patients are indicated for several AEDs. Extraordinary attention to continued drug need and heightened awareness of adverse drug reactions and interactions are warranted since the symptoms of prevalent comorbid conditions can mimic those of seizure disorders and adverse AED reactions.