A Prospective Observational Study on Changing Trends of Antiepileptics Prescription Amongst Physicians in India

Main Article Content

Sanjay K. Gupta Mukesh Kumar Garg Sejal Mehta Deepak Sen

Abstract

Epilepsy is one of the common neurological disease affecting millions of people worldwide. Multiple class of antiepileptic drugs (AEDs) are available which makes it difficult to select an appropriate drug therapy for epilepsy. With introduction of newer generation of antiepileptics, the drug Pool has become wider. Factors which determine the selection of therapy includes seizure type, adverse effect, drug-drug interaction, age, pregnancy, cost of treatment and drug compliance. Though the older generation of antiepileptics were effective in controlling seizures, we found that newer generation of antiepileptics are gaining popularity among the prescriber. Reason for this shift being, better efficacy, fewer side effect and better compliance by the patients. We completed the study with the conclusion that newer antiepileptic especially levetiracetam, are more preferred by doctors in comparison with older antiepileptic drugs for control of seizures, though previous generation of antiepileptics has still role in management of epilepsy and individualistic approach is needed in choosing appropriate antiepileptics.

Keywords: Epilepsy, Standard Antiepileptic, Compliance

Article Details

How to Cite
GUPTA, Sanjay K. et al. A Prospective Observational Study on Changing Trends of Antiepileptics Prescription Amongst Physicians in India. Medical Research Archives, [S.l.], v. 11, n. 4, apr. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3654>. Date accessed: 03 july 2024. doi: https://doi.org/10.18103/mra.v11i4.3654.
Section
Research Articles

References

1. Stafstrom CE, Carmant L. Seizures and epilepsy: an overview for neuroscientists. Cold Spring Harb Perspect Med. 2015;5(6):a022426. Published 2015 Jun 1. doi:10.1101/cshperspect.a022426.
2. Moshe SL, Perucca E, Ryvlin P, Tomson T. Epilepsy: new advances.Lancet. 2015;385(9971):884-898. doi:10.1016/S0140-6736(14)60456-6.
3. Perucca E.Current trends in antiepileptic drug therapy. Epilepsia.2003;44 Suppl 4:41-47.
doi:10.1046/j.1528-1157.44.s4.1.x.
4. PickrellWO, Lacey AS, Thomas RH, Lyons RA, Smith PE, Rees MI. Trends in the first Antiepileptic drugs prescribed for epilepsy between 2000 and 2010. Seizure.2014;23:77-80. doi:10.1016/j.seizure.2013.09.007
5. Britton JW, So EL. Selection of antiepileptic drugs: a practical approach. Mayoclin proc. 1996;71(8):778-786. doi:10.4065/71.8.778
6. French JA, Gazzola DM. Antiepileptic drug treatment: new drugs and new strategies. Continuum (Minneap Minn).2013;19(3 Epilepsy):643-655. doi:10.1212/01.CON.0000431380.21685.75
7. St Louis EK, Rosenfeld WE, Bramley T. Antiepileptic drugmonotherapy: the initial approach in epilepsy management. Curr Neuropharmacol. 2009;7(2):77-82. doi:10.2174/157015909788848866
8. HartSC. Antiepileptic Drugs: First generation. Epilepsy and Brain Tumors. 2015;159-169. doi:10.1016/B978-0-12-417043-8.00011-0
9. Joshi R, Tripathi M, Gupta P, Gulati S, Gupta YK. Prescription pattern of antiepileptic drugs in a tertiary care center of India. Indian J Pharmacol. 2020;52(4):283-289. doi:10.4103/ijp.IJP_507_17
10. Deckers CL, Knoester PD, de Haan GJ de, KeyserA, Renier WO, Hekster YA. Selection criteria for the clinical use of the newer antiepileptic drugs. CNS Drugs. 2003;17(6):405-421. doi:10.2165/00023210-200317060-00003
11. Perucca E. Marketed new antiepileptic drugs: are they better than old- generation agents?.Ther DrugMonit: 2002;24(1):74-80. doi:10.1097/00007691-200202000-00013
12. Perucca E. Clinical pharmacology and therapeutic use of the new antiepileptic drugs [published correction appears in Fundam Clin Pharmacol. 2002 Jun;16(3):249.].FundamClin Pharmacol. 2001;15(6):405-417. doi:10.1046/j.1472-8206.2001.00055.x
13. Hanaya R, Arita K. The New Antiepileptic Drugs: their Neuropharmacology and Clinical Indications. Neurol Med Chir (Tokyo). 2016;56(5):205-220. doi:10.2176/nmc.ra.2015-0344
14. French JA, Gazzola DM. New generation antiepileptic drugs: what do they offer in terms of improved tolerability and safety?.Ther Adv Drug Saf. 2011 Aug;2(4):141-158. doi:10.1177/2042098611411127.
15. Pellock JM. Treatment of epilepsy in the new millennium. Pharmacotherapy. 2000;20(8 Pt 2):129S-138S.
16. Abou-Khalil B. Levetiracetam in the treatment of epilepsy. Neuropsychiatr Distreat. 2008; 4(3):507-523. doi:10.2147/ndt.s2937.
17. Lyseng-WilliamsonKA. Levetiracetam:a review of its use in epilepsy. Drugs. 2011;71(4):489-514. doi:10.2165/11204490-000000000-00000.
18. Patsalos PN. Pharmacokinetic profile of levetiracetam: towards ideal characteristics. Pharmacol Ther. 2000;85(2):77-85.doi:10.1016/s0163-7258(99)00052-2.
19. JawaidW, Nisa Q, Umer SR, Barry SJ, Qureshi A, Shahbaj NN. Etiology and type of seizures in patients presenting to a tertiary care hospital in karachi : A cross - sectional study. Cureus 2020;12(7):e9194. Published 2020 Jul 15. doi:10.7759/cureus.9194.
20. French JA, Gazzola DM. New generation antiepileptic drugs: what do they offer in terms of improved tolerability and safety?Ther Adv Drug Saf. 2011 Aug;2(4):141-158. doi:10.1177/2042098611411127.
21. Mattson RH. Selection of drugs for the treatment of epilepsy. Semin Neurol. 1990;10(4):406-413. doi:10.1055/s-2008-1063985.
22. VidaurreJ, HerbstJ.Nuevos farmacosantiepilepticos [New antiepileptic drugs]. Medicina (B Aires).2019;79:48-53.
23. Mattson RH. Selection of drugs for the treatment of epilepsy. Semin Neurol. 1990;10(4):406-413. doi:10.1055/s-2008-1063985.
24. VidaurreJ, HerbstJ.Nuevos farmacosantiepilepticos [New antiepileptic drugs]. Medicina (B Aires).2019;79:48-53.
25. Coppola G, Piccorossi A, Operto FF, Verrotti A. Anticonvulsant drugs for generalized tonic-clonic epilepsy. Expert Opin on Pharmacother.2017;18(9):925-936. doi:10.1080/14656566.2017.1328499.
26. Mattson RH. Selection of drugs for the treatment of epilepsy. Semin Neurol. 1990;10(4):406-413. doi:10.1055/s-2008-1063985.
27. Elger CE, Brodie MJ, Anhut H, Lee CM, Barrett JA. Pregabalin add-on treatment in patients with partial seizures: a novel evaluation of flexible-dose treatment in a double-blind, placebo-controlled study. Epilepsia. 2005;46(12):1926-1936. doi:10.1111/j.1528-1167.2005.00341.x
28. Meador KJ, Penovich P, Baker GA, Pennell PB, Bromfield E, Pack A, Liporace JD, Sam M, Kalayjian LA, Thurman DJ, Moore E, Loring DW. Antiepileptic drugs use in women childbearing age. Epilepsy Behav. 2009;15(3):339-43. doi:10.1016/j.yebeh.2009.04.026.
29. Biton V. Effect of Antiepileptic Drugs on Body weight: overview and clinical implications for the treatment of epilepsy.CNS Drugs.2003;179(11):781-791. doi:10.2165/00023210-200317110-00002.
30. Elinor Ben- Menachem (2003) Levetiracetam: treatment in epilepsy, Expert Opinion on pharmacotherapy,4:11,2079-2088. doi:10.1517/14656566.4.11.2079.