Table 1.
Administration routes and characteristics of antiepileptic drugs relevant for palliative care.
| AED | Daily Dose | Special consideration for palliative care | IV | Liquid solution | Suspension | Tablet |
|---|---|---|---|---|---|---|
| Brivaracetam (BRV) | 50–200 mg | Mild CYP3A4 metabolism. Probably no clinical relevant interactions | + | + | – | + |
| Carbamazepine (CBZ) | 600–2000 mg | Dizziness, nausea, ataxia Effective for neuralgic pain (200-400 mg/d), decreases: VPA, TPM, LTG, neuroleptics, antimycotic agents, antidepressant drugs, steroid level Increases: diazepam level and effective CBZ- Metabolite Is decreased by: PHT Is increased by: Theophyllin, Cisplatin |
– | + | + | + |
| Eslicarbazepine (ESL) | 800–1600 mg (max. 1200 mg when combined with other AED) |
Dizziness, gait disturbance, ataxia, hyponatremia Is decreased by: PHT, CBZ Increases: PHT |
– | – | – | + |
| Gabapentin (GBP) | 900–3000 mg | Sedation (especially in combination with opioids), therapy of neuropathic pain (900 mg/d) Is increased by: morphine |
– | + | + | + |
| Lacosamide (LCM) | 100–600 mg (max. 400 mg when combined with other AEDs) |
Dizziness No relevant interactions |
+ | + | + | + |
| Lamotrigine (LTG) | 100–300 mg | Tremor, sedation (rare), sleep disturbance„ mood stabilizing effect. Very slow titration necessary Is decreased by: CBZ, PHT Is increased by: VPA |
– | – | + | + |
| Levetiracetam (LEV) | 1000–3000 mg (−4000 mg off-label) mg | Sedation (rare), psychiatric side effects No relevant interactions |
+ | + | + | + |
| Oxcarbazepine (OXC) | 900–2400 mg | Dizziness, nausea, ataxia (less often when the slow release form is used), hyponatraemia | – | + | + | + |
| Perampanel (PER) | 4–12 mg | Dizziness, somnolence Is decreased by: CBZ, OXC, TPM Decreases: CBZ, OXC, VPA |
– | – | – | + |
| Phenytoin (PHT) | 200–350 mg | Dizziness, allergy. Potentially complicated titration Decreases: steroid level |
+ | – | + | + |
| Pregabalin (PGB) | 150–600 mg | Sedation. No relevant interactions Anxiolytic effect. |
– | + | + | + |
| Topiramate (TPM) | 50–200 mg | Sedation, fatigue, lack of appetite, weight loss, paraesthesia, speech disturbances No relevant interactions |
– | – | + | + |
| Valproate (VPA) | 1200–2400 mg | Tremor, encephalopathy, mood stabilizing effect. Enzyme inhibition (leading e.g., to increased toxicity of chemotherapy). | + | + | + | + |