THE IMPACT OF MODERN ANTIEPILEPTIC DRUGS ON THE QUALITY OF LIFE OF PATIENTS WITH EPILEPSY

Аннотация

The study included general clinical and neurological examination, EEG and/or video EEG monitoring, RCT and/or MRI of the brain, neuropsychological testing using the QLIE- 31 and HUDS scales within 3 months from the start of therapy. The highest quality of life ratings were most often observed in the groups receiving levetiracetam and oxcarbazepine (83.3 and 72%, respectively), the highest frequency of low ratings among those taking carbamazepine and valproates (16.5 and 17%). Clinically significant psychoemotional disorders were more often observed with the use of topiramate (21.8%), valproates (21.4%) and carbamazepine (16.6%), much less frequently with oxcarbazepine (8.3%), and were absent during treatment with levetiracetam. There is a strong correlation between the quality of life and the effectiveness and side effects of therapy, psychoemotional disorders. The best indicators of quality of life were observed with the use of new generation antiepileptic drugs. Keywords: epilepsy, antiepileptic drugs, quality of life. ВЛИЯНИЕ СОВРЕМЕННЫХ ПРОТИВОЭПИЛЕПТИЧЕСКИХ ПРЕПАРАТОВ НА КАЧЕСТВО ЖИЗНИ БОЛЬНЫХ ЭПИЛЕПСИЕЙ Аннотация. Исследование включало общеклиническое и неврологическое обследование, ЭЭГ и/или видеоЭЭГ-мониторинг, РКТ и/или МРТ головного мозга, нейропсихологическое тестирование по шкалам QLIE-31 и HUDS в течение 3 месяцев от начала терапии. Наиболее высокие оценки качества жизни чаще всего наблюдались в группах, получавших леветирацетам и окскарбазепин (83,3 и 72% соответственно), наибольшая частота низких оценок — среди принимавших карбамазепин и вальпроаты (16,5 и 17%). Клинически значимые психоэмоциональные нарушения чаще наблюдались при применении топирамата (21,8%), вальпроатов (21,4%) и карбамазепина (16,6%), значительно реже — окскарбазепина (8,3%), и отсутствовали при лечении 2 7 International scientific journal ISSN: 2181-3906 «MODERN SCIENCE АND RESEARCH» 2025 VOLUME 4 / ISSUE 1 / UIF:8.2 / MODERNSCIENCE.UZ леветирацетамом. Существует сильная корреляционная связь между качеством жизни и эффективностью и побочными эффектами терапии, психоэмоциональными нарушениями. Наилучшие показатели качества жизни наблюдались при применении противоэпилептических препаратов нового поколения. Ключевые слова: эпилепсия, противоэпилептические препараты, качество жизни. Introduction. The treatment strategy for epilepsy has now undergone significant changes. The modern approach to the problem of epilepsy treatment provides for the solution of a number of issues related not only to achieving maximum therapeutic effect, but also to the adequate and comfortable functioning of patients in society (education, choice of profession, employment, family creation). If it was back in the 50s and 80s. last century, the priority of therapy was epilepsy as a disease, and the goal is to eliminate seizures and psychoemotional disorders, then at the present stage the priority is the patient, and the goal is to improve his quality of life (QL) [3]. According to the definition of the World Health Organization, QL is people's perception of their position in life in the context of cultural and value orientations in accordance with their own goals, expectations, standards and concerns (cited in [4]). QL is defined as a person's satisfaction with their physical, mental and social well-being in all aspects of their functioning in society. Numerous studies have found a significant deterioration in QL in patients with epilepsy compared to the rest of the population [6]. The factors that reduce QL in epilepsy are very diverse. Often, the diagnosis of epilepsy itself turns out to be dramatic for the patient, causing social disadaptation, contributing to psychological distress and a decrease in quality of life [7, 9]. Epileptic seizures, fear of their recurrence and the wary attitude of others towards them also have a negative impact [10]. Seizures are associated with an increased risk of developing mental and cognitive disorders, causing damage to physical health [8]. One of the most significant negative factors is the need for prolonged (sometimes lifelong) use of antiepileptic drugs (PEP), which themselves can reduce QL, causing physical, mental and cognitive disorders, and have teratogenic effects [5]. In some cases, the PEP itself has a negative effect on the course of the disease and the severity of seizures [2]. Thus, the problem of quality of life in patients with epilepsy is associated not only with the clinical manifestations of the disease, but also with a personal reaction to it, with the need for constant medication, with the attitude of society towards patients, which does not always reasonably limit their desire for social activity [4]. In modern epileptology, one of the priority goals is to improve quality of life and rehabilitation of patients with epilepsy 2 8 International scientific journal ISSN: 2181-3906 «MODERN SCIENCE АND RESEARCH» 2025 VOLUME 4 / ISSUE 1 / UIF:8.2 / MODERNSCIENCE.UZ [1]. Until recently, valproates an