{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T22:37:32Z","timestamp":1791067052104,"version":"4.1.0"},"reference-count":93,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[1998,5,1]],"date-time":"1998-05-01T00:00:00Z","timestamp":893980800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[1998,5]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To describe the primary types of antiepileptic drug (AED) interactions by using a mechanistic approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA SOURCES:<\/jats:title>\n                    <jats:p>A literature search was performed using MEDLINE and bibliographies of recent review articles and published abstracts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>AEDs are associated with a wide range of drug interactions, including hepatic enzyme induction and inhibition and protein-binding displacement. Hepatic induction by AEDs affects the metabolism of a limited number of drugs with low therapeutic indices. Anticipation of induction interactions and careful clinical monitoring may alleviate potential problems. Most commonly used AEDs are eliminated through hepatic metabolism catalyzed by the cytochrome P450 (CYP) and uridine diphosphate glucuronosyltransferase (UGT) enzymes. Phenytoin, phenobarbital, and carbamazepine induce CYP and UGT enzymes. Lamotrigine is a weak inducer of UGT. Valproate is a broad-spectrum inhibitor of UGT enzymes, epoxide hydrolase, and CYP2C enzymes. Felbamate induces CYP3A4, but inhibits CYP2C19 substrates. Topiramate inhibits only CYP2C19 substrates. Ethosuximide, gabapentin, tiagabine, and vigabatrin are neither inducers nor inhibitors of drug metabolism. Hepatic enzyme inhibition usually occurs because of competition at the enzyme site. Knowledge of the specific metabolic enzymes involved in the metabolism of AEDs allows clinicians to predict potential interactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>By understanding the mechanisms of drug interactions, the pharmacist can play a key role in patient care by anticipating and preventing AED drug interactions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.17332","type":"journal-article","created":{"date-parts":[[2004,3,11]],"date-time":"2004-03-11T17:08:19Z","timestamp":1079024899000},"page":"554-563","source":"Crossref","is-referenced-by-count":203,"title":["A Mechanistic Approach to Antiepileptic Drug Interactions"],"prefix":"10.1177","volume":"32","author":[{"given":"Gail D","family":"Anderson","sequence":"first","affiliation":[{"name":"Gail D Anderson PhD, Associate Professor, Department of Pharmacy, School of Pharmacy, University of Washington, Box 357630, Seattle, WA 98195, FAX 206\/543-3835"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[1998,5,1]]},"reference":[{"key":"bibr1-aph.17332","first-page":"317","volume":"19","author":"Conney AH","year":"1967","journal-title":"Pharmacol Rev"},{"key":"bibr2-aph.17332","first-page":"315","volume-title":"Antiepileptic drugs","author":"Kutt H","year":"1995","edition":"4"},{"key":"bibr3-aph.17332","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199018010-00003"},{"key":"bibr4-aph.17332","first-page":"389","volume-title":"Antiepileptic drugs","author":"Kutt H","year":"1995","edition":"4"},{"key":"bibr5-aph.17332","first-page":"449","volume-title":"Antiepileptic drugs","author":"Bourgeois BFD","year":"1995","edition":"4"},{"key":"bibr6-aph.17332","first-page":"467","volume-title":"Antiepileptic drugs","author":"Fincham RW","year":"1995","edition":"4"},{"key":"bibr7-aph.17332","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199631030-00004"},{"key":"bibr8-aph.17332","first-page":"543","volume-title":"Antiepileptic drugs","author":"Levy RH","year":"1995","edition":"4"},{"key":"bibr9-aph.17332","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.1984.tb02482.x"},{"key":"bibr10-aph.17332","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-198909000-00008"},{"key":"bibr11-aph.17332","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.1988.tb05274.x"},{"key":"bibr12-aph.17332","doi-asserted-by":"publisher","DOI":"10.3109\/03602538109011082"},{"key":"bibr13-aph.17332","first-page":"414","volume":"270","author":"Shimada T","year":"1994","journal-title":"J Pharmacol Exp Ther"},{"key":"bibr14-aph.17332","doi-asserted-by":"publisher","DOI":"10.3109\/10408449209145319"},{"key":"bibr15-aph.17332","doi-asserted-by":"publisher","DOI":"10.1016\/0006-2952(94)90071-X"},{"key":"bibr16-aph.17332","first-page":"329","volume-title":"Antiepileptic drugs","author":"Levy RH","year":"1995","edition":"4"},{"key":"bibr17-aph.17332","first-page":"1401","volume":"24","author":"Bajpai M","year":"1996","journal-title":"Drug Metab Dispos"},{"key":"bibr18-aph.17332","first-page":"259","volume":"10","author":"Hargraves JA","year":"1996","journal-title":"Int Soc Stud Xenobiotics Proc"},{"key":"bibr19-aph.17332","first-page":"87","volume":"8","author":"Sadeque AJM","year":"1995","journal-title":"Int Soc Stud Xenobiotics Proc"},{"key":"bibr20-aph.17332","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1996.00550110143027"},{"key":"bibr21-aph.17332","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199733030-00004"},{"key":"bibr22-aph.17332","first-page":"659","volume-title":"Antiepileptic drugs","author":"Bialer M","year":"1995","edition":"4"},{"key":"bibr23-aph.17332","doi-asserted-by":"publisher","DOI":"10.1159\/000138990"},{"key":"bibr24-aph.17332","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1995.tb06007.x"},{"key":"bibr25-aph.17332","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199732030-00004"},{"key":"bibr26-aph.17332","first-page":"64","volume":"12","author":"Hurst SI","year":"1997","journal-title":"Int Soc Stud Xenobiotics Proc"},{"key":"bibr27-aph.17332","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.1994.tb04375.x"},{"key":"bibr28-aph.17332","unstructured":"Yau MK, Adams MA, Warfin WA, Lai AA. 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