REVIEW article

Front. Pharmacol.

Sec. Pharmacoepidemiology

Volume 16 - 2025 | doi: 10.3389/fphar.2025.1584566

This article is part of the Research TopicEmerging Trends in Real-World Pharmacoepidemiology and Drug Safety: 2025View all 3 articles

Adverse effects of antiseizure drugsmedications: a review of the impact of pharmacogenetics and drugs interactions in clinical practice

Provisionally accepted
Michela De BellisMichela De Bellis1Giuseppe d'OrsiGiuseppe d'Orsi2Egidio Maria RubinoEgidio Maria Rubino1Claudia AriglianoClaudia Arigliano1Massimo CarellaMassimo Carella2Vittorio SciruicchioVittorio Sciruicchio3Antonella LiantonioAntonella Liantonio1Annamaria De LucaAnnamaria De Luca1Paola ImbriciPaola Imbrici1*
  • 1Department of Pharmacy and Pharmaceutical Sciences, University of Bari Aldo Moro, Bari, Italy
  • 2Complex Operative Unit of Neurology, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
  • 3Children Epilepsy and EEG Center, San Paolo Hospital, ASL Bari, Bari, Italy

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Epilepsy is a chronic and debilitating neurological disorder characterized by the occurrence of spontaneous and recurrent seizures. Despite the availability of several antiseizure medications (ASMs), people with epilepsy often experience drug resistance and adverse effects. This narrative review provides an overview of the main adverse drug reactions (ADR) caused by ASMs, including neurological, metabolic, skin reactions and drug failure, and of the underlying molecular mechanisms. Given the critical contribution of pharmacogenomics and drug-drug interactions to the occurrence of some ADRs, we provide examples of the role of major allelic variations identified in genes encoding for molecules involved in the pharmacokinetics, pharmacodynamics and immune system and emphasize the activity of ASMs as inhibitors or inducers of metabolic enzymes. Improved knowledge of the benefit-risk profile of drugs, also through enhanced pharmacovigilance activity and following guidelines recommendations, could implement patients care avoiding ADRs and favoring a beneficial personalized medicine particularly in vulnerable patients as children, elderly people and pregnant women.

Keywords: Epilepsy, pharmacogenomics, polymorphisms, therapy, adverse effects, Pharmacovigilance

Received: 27 Feb 2025; Accepted: 24 Jun 2025.

Copyright: © 2025 De Bellis, d'Orsi, Rubino, Arigliano, Carella, Sciruicchio, Liantonio, De Luca and Imbrici. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Paola Imbrici, Department of Pharmacy and Pharmaceutical Sciences, University of Bari Aldo Moro, Bari, 70125, Italy

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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