Imperial College London


Faculty of MedicineDepartment of Brain Sciences

Professor of Neurology and Genomic Medicine



m.johnson Website




E419Burlington DanesHammersmith Campus






BibTex format

author = {Silvennoinen, K and de, Lange N and Zagaglia, S and Balestrini, S and Androsova, G and Wassenaar, M and Auce, P and Avbersek, A and Becker, F and Berghuis, B and Campbell, E and Coppola, A and Francis, B and Wolking, S and Cavalleri, GL and Craig, J and Delanty, N and Johnson, MR and Koeleman, BPC and Kunz, WS and Lerche, H and Marson, AG and O'Brien, TJ and Sander, JW and Sills, GJ and Striano, P and Zara, F and van, der Palen J and Krause, R and Depondt, C and Sisodiya, SM and EpiPGX, Consortium},
doi = {10.1002/epi4.12349},
journal = {Epilepsia Open},
pages = {420--430},
title = {Comparative effectiveness of antiepileptic drugs in juvenile myoclonic epilepsy},
url = {},
volume = {4},
year = {2019}

RIS format (EndNote, RefMan)

AB - Objective: To study the effectiveness and tolerability of antiepileptic drugs (AEDs) commonly used in juvenile myoclonic epilepsy (JME). Methods: People with JME were identified from a large database of individuals with epilepsy, which includes detailed retrospective information on AED use. We assessed secular changes in AED use and calculated rates of response (12-month seizure freedom) and adverse drug reactions (ADRs) for the five most common AEDs. Retention was modeled with a Cox proportional hazards model. We compared valproate use between males and females. Results: We included 305 people with 688 AED trials of valproate, lamotrigine, levetiracetam, carbamazepine, and topiramate. Valproate and carbamazepine were most often prescribed as the first AED. The response rate to valproate was highest among the five AEDs (42.7%), and significantly higher than response rates for lamotrigine, carbamazepine, and topiramate; the difference to the response rate to levetiracetam (37.1%) was not significant. The rates of ADRs were highest for topiramate (45.5%) and valproate (37.5%). Commonest ADRs included weight change, lethargy, and tremor. In the Cox proportional hazards model, later start year (1.10 [1.08-1.13], P < 0.001) and female sex (1.41 [1.07-1.85], P = 0.02) were associated with shorter trial duration. Valproate was associated with the longest treatment duration; trials with carbamazepine and topiramate were significantly shorter (HR [CI]: 3.29 [2.15-5.02], P < 0.001 and 1.93 [1.31-2.86], P < 0.001). The relative frequency of valproate trials shows a decreasing trend since 2003 while there is an increasing trend for levetiracetam. Fewer females than males received valproate (76.2% vs 92.6%, P = 0.001). Significance: In people with JME, valproate is an effective AED; levetiracetam emerged as an alternative. Valproate is now contraindicated in women of childbearing potential without special precautions. Wi
AU - Silvennoinen,K
AU - de,Lange N
AU - Zagaglia,S
AU - Balestrini,S
AU - Androsova,G
AU - Wassenaar,M
AU - Auce,P
AU - Avbersek,A
AU - Becker,F
AU - Berghuis,B
AU - Campbell,E
AU - Coppola,A
AU - Francis,B
AU - Wolking,S
AU - Cavalleri,GL
AU - Craig,J
AU - Delanty,N
AU - Johnson,MR
AU - Koeleman,BPC
AU - Kunz,WS
AU - Lerche,H
AU - Marson,AG
AU - O'Brien,TJ
AU - Sander,JW
AU - Sills,GJ
AU - Striano,P
AU - Zara,F
AU - van,der Palen J
AU - Krause,R
AU - Depondt,C
AU - Sisodiya,SM
AU - EpiPGX,Consortium
DO - 10.1002/epi4.12349
EP - 430
PY - 2019///
SN - 2470-9239
SP - 420
TI - Comparative effectiveness of antiepileptic drugs in juvenile myoclonic epilepsy
T2 - Epilepsia Open
UR -
UR -
UR -
VL - 4
ER -