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Medications, epilepsy and climate change: Added layers of complexity

Gulcebi, Medine I; Gavas, Seyhmus; Sisodiya, Sanjay M; (2025) Medications, epilepsy and climate change: Added layers of complexity. British Journal of Clinical Pharmacology , 91 (8) pp. 2205-2221. 10.1002/bcp.70108. Green open access

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Abstract

Climate change—the global crisis with pervasive health impacts—has adverse consequences for people with epilepsy (PWE) who have low quality of life due to poor seizure control, socioeconomic disadvantages and comorbidities. This review focuses on the potential effects of climate change on the pharmacological characteristics of antiseizure medications (ASMs), antipsychotics and antidepressants. We note that findings particularly obtained from physicochemical stability studies have been demonstrated experimentally for some specific environmental conditions whereas studies for clinical outcome effects are very limited. Carbamazepine, valproate, phenytoin or lorazepam appear to be ASMs at risk of being affected by high temperature and/or humidity. Even the stability of blood samples needs to be considered during transportation to therapeutic drug monitoring units, particularly for the PWE living in low-income countries that are facing the most challenges of climate change effects attributed to low infrastructure and healthcare system capacity. We need more urgent research investigating drug responses of PWE regarding especially the effects of adverse weather events such as heatwaves on physicochemical stability or pharmacokinetics of drugs in a complex interaction with the vulnerabilities of individuals, accompanying neuropsychiatric disorders and geographical challenges. Then we will be able to develop pharmacological treatment strategies to improve the quality of life of PWE during adverse weather events.

Type: Article
Title: Medications, epilepsy and climate change: Added layers of complexity
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/bcp.70108
Publisher version: https://doi.org/10.1002/bcp.70108
Language: English
Additional information: Copyright © 2025 The Author(s). British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society. This is an open access article under the terms of the Creative Commons Attribution License, https://creativecommons.org/licenses/by/4.0/, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: Adverse weather events; global warming; neuropsychiatric drugs; pharmacokinetics
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
URI: https://discovery.ucl.ac.uk/id/eprint/10213495
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