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Impact of Antiseizure Medications on Appetite and Weight in Children

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Abstract

There are numerous potential factors that may affect growth in children with epilepsy, and these must be evaluated in any child with appetite and weight concerns. Antiseizure medications (ASMs) have potential adverse effects, and many may affect appetite, thus impacting normal growth and weight gain. The aim of this review is to focus on the impact of both epilepsy and ASMs on appetite and weight in children. We systematically reviewed studies using Medline assessing the impact of ASMs on appetite and weight in children. Eligible studies included randomized controlled trials and open-label studies (open-label extension and interventional) that targeted or included the pediatric population (0–18 years of age). Each study was classified using the American Academy of Neurology (AAN) Classification of Evidence for Therapeutic Studies, and the level of evidence for impact on appetite and weight in children was graded. ASMs associated with decreased appetite and/or weight loss include fenfluramine, topiramate, zonisamide, felbamate, rufinamide, stiripentol, cannabidiol, brivaracetam and ethosuximide; ASMs with minimal impact on weight and appetite in children include oxcarbazepine, eslicarbazepine, lamotrigine, levetiracetam, lacosamide, carbamazepine, vigabatrin and clobazam. The ASM most robustly associated with increased appetite and/or weight gain is valproic acid; however, both pregabalin and perampanel may also lead to modest weight gain or increased appetite in children. Certain ASMs may impact both appetite and weight, which may lead to increased morbidity of the underlying disease and impaired adherence to the treatment regimen.

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Author notes

  1. Ersida Buraniqi and Hicham Dabaja Shared first authorship.

Authors and Affiliations

  1. Division of Child and Adolescent Neurology, Department of Neurology, Mayo Clinic, 200 First St., SW, Rochester, MN, 55905, USA

    Ersida Buraniqi, Hicham Dabaja & Elaine C. Wirrell

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  1. Ersida Buraniqi
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  2. Hicham Dabaja
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  3. Elaine C. Wirrell
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Correspondence to Elaine C. Wirrell.

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All authors contributed to the study conception and design. Literature search, data analysis and draft were performed by EB, HD and EW. Critically revision was performed by EW. All authors have read and approve the final submitted manuscript and agree to be accountable for the work.

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Buraniqi, E., Dabaja, H. & Wirrell, E.C. Impact of Antiseizure Medications on Appetite and Weight in Children. Pediatr Drugs 24, 335–363 (2022). https://doi.org/10.1007/s40272-022-00505-2

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