{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T08:50:38Z","timestamp":1769331038613,"version":"3.49.0"},"reference-count":56,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T00:00:00Z","timestamp":1753488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016928","name":"E022 Program of the National Institute of Pediatrics","doi-asserted-by":"publisher","award":["090\/2012"],"award-info":[{"award-number":["090\/2012"]}],"id":[{"id":"10.13039\/100016928","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Epilepsy is a chronic neurological disease with a relatively high incidence in the pediatric population. Anti-seizure medication (ASM) may cause adverse drug reactions (ADRs), which may occur repeatedly. Objective: This study aimed to analyze the recurrence of ADRs caused by ASMs over a period of 122 months in hospitalized Mexican pediatric epilepsy patients. The patients were under monotherapy or polytherapy treatment, with valproic acid (VPA), phenytoin (PHT), and levetiracetam (LEV), among others. A total of 313 patients met the inclusion criteria: 211 experienced ADRs, whereas 102 did not. Patient sex, age, seizure type, nutritional status and related drugs were considered explanatory variables. Methods: Four statistical models were used to analyze recurrent events that were defined as \u201cone or more ADRs occurred on a single day\u201d, considering both the classification of ADR seriousness and the ASM causing the ADR. Results: A total of 499 recurrence events were identified. The recurrence risk was significantly greater among younger patients for both nonsevere and severe ADRs and among those with focal seizures for nonsevere ADRs. Interestingly, malnutrition was negatively associated with the risk of nonsevere ADRs, and obesity was positively associated with the risk of severe ADRs. Finally, LEV was associated with a significantly greater risk of causing nonsevere ADRs than VPA. However, LEV significantly reduced the risk of severe ADRs compared with VPA, and PHT increased the risk in comparison with VPA. In conclusion, this study offers a robust clinical tool to predict risk factors for the presence and recurrence of ASM-ADRs in pediatric patients with epilepsy.<\/jats:p>","DOI":"10.3390\/ph18081116","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T07:57:24Z","timestamp":1753689444000},"page":"1116","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Analysis of the Recurrence of Adverse Drug Reactions in Pediatric Patients with Epilepsy"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0613-8196","authenticated-orcid":false,"given":"Ernestina","family":"Hern\u00e1ndez Garc\u00eda","sequence":"first","affiliation":[{"name":"Laboratorio de Farmacolog\u00eda, Subdirecci\u00f3n de Medicina Experimental, Instituto Nacional de Pediatr\u00eda, Ciudad de M\u00e9xico 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9546-5545","authenticated-orcid":false,"given":"Brenda","family":"Lambert Lamazares","sequence":"additional","affiliation":[{"name":"Programa de Maestr\u00eda y Doctorado en Ciencias Matem\u00e1ticas y de la Especializaci\u00f3n en Estad\u00edstica Aplicada, Instituto de Investigaciones en Matem\u00e1ticas Aplicadas y en Sistemas, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Ciudad de M\u00e9xico 04510, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7519-5664","authenticated-orcid":false,"given":"Gisela","family":"G\u00f3mez-Lira","sequence":"additional","affiliation":[{"name":"Departamento de Farmacobiolog\u00eda, Centro de Investigaci\u00f3n y Estudios Avanzados del Instituto Polit\u00e9cnico Nacional, Ciudad de M\u00e9xico 14330, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0702-5318","authenticated-orcid":false,"given":"Julieta Griselda","family":"Mendoza-Torreblanca","sequence":"additional","affiliation":[{"name":"Laboratorio de Neurociencias, Subdirecci\u00f3n de Medicina Experimental, Instituto Nacional de Pediatr\u00eda, Ciudad de M\u00e9xico 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela","family":"Duke Lomeli","sequence":"additional","affiliation":[{"name":"Laboratorio de Farmacolog\u00eda, Subdirecci\u00f3n de Medicina Experimental, Instituto Nacional de Pediatr\u00eda, Ciudad de M\u00e9xico 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2624-9026","authenticated-orcid":false,"given":"Yessica","family":"L\u00f3pez Flores","sequence":"additional","affiliation":[{"name":"Laboratorio de Farmacolog\u00eda, Subdirecci\u00f3n de Medicina Experimental, Instituto Nacional de Pediatr\u00eda, Ciudad de M\u00e9xico 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura Elena","family":"Rangel Escobar","sequence":"additional","affiliation":[{"name":"Laboratorio de Farmacolog\u00eda, Subdirecci\u00f3n de Medicina Experimental, Instituto Nacional de Pediatr\u00eda, Ciudad de M\u00e9xico 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0240-9857","authenticated-orcid":false,"given":"Er\u00e9ndira","family":"Mej\u00eda Arangur\u00e9","sequence":"additional","affiliation":[{"name":"Departamento de Innovaci\u00f3n M\u00e9dica, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano del Seguro Social para el Bienestar, Estado de M\u00e9xico 56530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Ruiz-Velasco Acosta","sequence":"additional","affiliation":[{"name":"Departamento de Probabilidad y Estad\u00edstica, Instituto de Investigaciones en Matem\u00e1ticas Aplicadas y en Sistemas, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Ciudad de M\u00e9xico 04510, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9078-6363","authenticated-orcid":false,"given":"Lizbeth","family":"Naranjo Albarr\u00e1n","sequence":"additional","affiliation":[{"name":"Departamento de Matem\u00e1ticas, Facultad de Ciencias, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Ciudad de M\u00e9xico 04510, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,26]]},"reference":[{"key":"ref_1","unstructured":"(2025, June 19). 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