Belančić, Andrej; Fajkić, Almir; Wah Lam, Yun; Alić, Lejla; Labriffe, Marc; Pilipović, Kristina; Džidić-Krivić, Amina; Yee Sy, Hing; Jankovic, Slobodan
doi: 10.1080/17425255.2026.2650187pmid: 41885274
Falcicchio, Giovanni; Nucera, Bruna; Giuliano, Loretta; Castellucci, Giovanni; Colonna, Isabella; Russo, Emilio
doi: 10.1080/17425255.2026.2650186pmid: 41863508
Introduction Absorption, distribution, metabolism and excretion of antiseizure medications may undergo significant modifications throughout pregnancy. These necessitate careful and proactive monitoring to avoid breakthrough seizures during pregnancy with potentially lethal consequences for both mother and child. Areas covered Based on the available literature, pharmacokinetics of both older and newer antiseizure medications are examined by the authors, emphasizing the important available data and the missing ones for which it is necessary to expand knowledge. Expert opinion Therapeutic drug monitoring is a valuable tool for tailoring antiseizure treatment in women with epilepsy. When monitoring is not feasible, clinicians may need to adjust doses based on seizure severity and the well-documented pharmacokinetic changes of specific medications such as lamotrigine, levetiracetam, oxcarbazepine. The goal is to maintain effective seizure control while minimizing teratogenic risks and ensuring safe fetal development.
Spina, Edoardo; Barbieri, Maria Antonietta; Alborghetti, Marika; Nicoletti, Ferdinando; de Leon, Jose
doi: 10.1080/17425255.2026.2650188pmid: 41873592
Introduction This is an update of a prior review of clinically relevant pharmacokinetic (PK) and pharmacodynamic (PD) drug-drug interactions (DDIs) between antidepressants and antiseizure medications (ASMs). Area covered Articles published between 1 January 2010 and 30 November 2025 were identified through structured searches in PubMedⓇ, Web of Science, SCOPUS, and Google Scholar using antidepressant- and ASM-related terms. Some antidepressants, including fluoxetine, paroxetine, fluvoxamine, are moderate to strong inhibitors of various cytochrome P450 (CYP) isoenzymes and may cause clinically relevant interactions with ASMs metabolized by these pathways. First-generation ASMs with enzyme-inducing properties (e.g. carbamazepine, phenobarbital, and phenytoin) or enzyme-inhibiting effects (e.g. valproic acid) may alter the PK profile of several antidepressants, potentially leading to reduced therapeutic efficacy or dose-dependent toxicity. The introduction of second- and third-generation ASMs has substantially improved the safety of combined pharmacotherapy. Potential PD DDIs between antidepressants and ASMs are less clearly defined and remain largely theoretical. Expert opinion Antidepressants and ASMs are associated with a considerable risk of clinically significant DDIs. A thorough understanding of the underlying PK and PD mechanisms, combined with complementary strategies including therapeutic drug monitoring, consultation of interaction databases, and careful clinical monitoring, is essential to anticipate, prevent, and effectively manage adverse DDIs.
Yao, Haiping; Gan, Guoping; Wang, Zhu
doi: 10.1080/17425255.2026.2660710pmid: 41978482
Background Tedizolid (TED), an oxazolidinone antibiotic, has improved pharmacokinetics compared with linezolid, but its real-world safety profile remains incompletely defined. Post-marketing surveillance helps detect adverse drug reactions (ADRs) not fully captured in clinical trials. Research design and methods This retrospective pharmacovigilance study analyzed adverse event (AE) reports listing TED as the primary suspect drug in the U.S. FDA Adverse Event Reporting System (July 2014 – June 2025). Demographics, clinical indications, and outcomes were summarized descriptively. Disproportionality analyses—reporting odds ratio, proportional reporting ratio, Bayesian confidence propagation neural network, and multi-item gamma Poisson shrinker—were applied at the system-organ class (SOC) and preferred term (PT) levels, requiring simultaneous positivity. Results Among 14,919,217 AE reports, 494 involved TED. Hematologic toxicities were consistently detected, aligning with known risks. PT-level analysis identified potential emerging safety signals, including hepatic cytolysis, gamma-glutamyltransferase increased, mental status changes, tooth discoloration, and melena. Median onset among evaluable cases (n = 386) was three days, with nearly one-third occurring as true same-day events (Day 0). Conclusions Post-marketing data confirm TED’s hematologic risks and reveal additional potential hepatic, neuropsychiatric, and gastrointestinal signals. These findings merit further evaluation and prospective studies to clarify clinical significance, establish causality, and optimize monitoring strategies.
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