已知约有10%的艾滋病患者伴有癫痫。最近，美国神经科学协会发布的新指南强调“正在服用抗艾滋病药物的患者兼有癫痫者，需慎用抗癫痫药如苯巴比妥、卡马西平等，因为后者不仅可以显著降低抗艾滋病药物在患者血液中的浓度，进而影响抗艾滋病的疗效，亦可增加药物的毒性”。

New Guidelines Issued for Combining HIV, Seizure Meds

Doctors urged to use caution in treating HIV/AIDS patients who experience seizures

WEDNESDAY, Jan. 4 (HealthDay News) -- Physicians need to take care when prescribing seizure medication to HIV/AIDS patients to prevent harmful interactions between drugs, experts warn.

The cautionary note from the American Academy of Neurology (AAN) has led to the issuance of a new AAN guideline, which was developed in consultation with the International League Against Epilepsy.

"It is important that patients know exactly which drugs they are taking and provide that information to all prescribing health care providers caring for them," lead guideline author Dr. Gretchen L. Birbeck, of Michigan State University, said in an AAN news release.

"Doctors may need to watch and adjust drug doses in people with HIV/AIDS who take seizure drugs," added Birbeck, who is also an AAN fellow.

Seizures and related disorders are not uncommon among HIV patients, according to Birbeck and colleagues. It is estimated that at least 10 percent of HIV patients experience seizures, they noted.

In the new guideline, published in the Jan. 4 online editions of both Neurology and Epilepsia, the research team cautioned that effectiveness of either set of drugs can be compromised when specific seizure medications are taken alongside certain HIV/AIDS treatments. Increased toxicity is another potential issue.

For example, levels of HIV/AIDS drugs can actually drop when they come into contact with certain seizure medications, such as phenytoin, phenobarbital and carbamazepine. The risk: an HIV drug regimen might fail, the authors pointed out.

One way Birbeck's team hopes to mitigate against such risk is to outline the correct dosages of seizure drugs. They noted that dangerous drug interactions may be avoidable if medications are prescribed in the right amounts.

The research team also said that the threat of harmful drug interactions is highest in places where drug choices are the most curtailed. That means that patients in poorer countries, where most HIV/AIDS patients now live, are particularly vulnerable.

"Future research should target epilepsy and HIV/AIDS drug combinations where choices are limited, such as in developing countries, to better understand the risk of these drug interactions," Birbeck said in the news release.

SOURCE: American Academy of Neurology, news release, Jan. 4, 2012