Exploring Prescription Patterns and Patient Characteristics in Antiepileptic Therapy: A Retrospective Observational Study Menjelajahi Pola Resep dan Karakteristik Pasien dalam Terapi Antiepilepsi: Studi Observasional Retrospektif
- Antiepileptic therapy,
- Prescription patterns,
- Patient characteristics,
- Epilepsy management,
- Combination therapy
Copyright (c) 2023 Martanty Aditya, Godeliva Andriani Hendra, Putera Maitreya
This work is licensed under a Creative Commons Attribution 4.0 International License.
This retrospective observational study aimed to provide an overview of prescribed antiepileptic therapy utilization and patient profiles. Conducted at a Neurology Polyclinic, data from December 2022 to January 2023 were analyzed descriptively. Among 35 eligible patients, the majority were male (68.57%), aged 15-25 years (48.57%), with long-standing epilepsy (54.28%), and absence of recent seizures (54.28%) and comorbidities (62.85%). Monotherapy was employed for 51.43%, while 48.57% received combination therapy. Phenytoin emerged as the most frequently prescribed monotherapy (25.71%), and valproic acid combined with phenytoin was the prominent combination (14.28%). This study highlights the prevalence of phenytoin and valproic acid usage, suggesting the need for further investigation into their efficacy and implications for epilepsy management.
- Diverse Prescription Patterns: The study reveals a range of antiepileptic therapy prescriptions, with phenytoin and valproic acid being the predominant choices in both single and combination forms.
- Patient Profiles and Demographics: The analysis focuses on male-dominated respondents aged 15-25 years, emphasizing the importance of understanding patient characteristics for tailored epilepsy management strategies.
- Implications for Treatment Strategies: The findings underscore the significance of evaluating the efficacy and clinical implications of commonly prescribed antiepileptic drugs, guiding clinicians in optimizing epilepsy treatment regimens.
Keywords: Antiepileptic therapy, Prescription patterns, Patient characteristics, Epilepsy management, Combination therapy.
- E. Beghi, “The Epidemiology of Epilepsy,” Neuroepidemiology, vol. 54, no. 2, pp. 185–191, 2020.
- J. J. Falco-Walter, I. E. Scheffer, and R. S. Fisher, “The new definition and classification of seizures and epilepsy,” Epilepsy Res., vol. 139, no. July 2017, pp. 73–79, 2018.
- T. A. Milligan, “Epilepsy: A Clinical Overview,” Am. J. Med., vol. 134, no. 7, pp. 840–847, 2021.
- K. J. Hamilton, Z. Chen, A. Tomlin, and P. Kwan, “Mortality and morbidity of patients with treated and untreated epilepsy in New Zealand,” Epilepsia, vol. 61, no. 3, pp. 519–527, 2020.
- Q. Peng, M. Ma, X. Gu, Y. Hu, and B. Zhou, “Evaluation of Factors Impacting the Efficacy of Single or Combination Therapies of Valproic Acid, Carbamazepine, and Oxcarbazepine: A Longitudinal Observation Study,” Front. Pharmacol., vol. 12, no. May, pp. 1–13, 2021.
- N. Li, J. Li, D. Zhao, and W. Lin, “Efficacy of phenobarbital in treating elderly epilepsy patients in rural northeast China: A community-based intervention trial,” Seizure, vol. 89, no. May, pp. 93–98, 2021.
- T. Glauser et al., “ILAE treatment guidelines: Evidence-based analysis of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes,” Epilepsia, vol. 47, no. 7, pp. 1094–1120, 2006.
- S. Dey, A. K. Kem, Yatish, and S. Agarwal, “Efficacy and safety of phenytoin versus clobazam as monotherapy for newly diagnosed epileptic patients,” Asian J. Med. Sci., vol. 13, no. 3, pp. 95–100, 2022.
- J. Patocka, Q. Wu, E. Nepovimova, and K. Kuca, “Phenytoin – An anti-seizure drug: Overview of its chemistry, pharmacology and toxicology,” Food Chem. Toxicol., vol. 142, no. May, p. 111393, 2020.
- Yovita Karina Pandan Putri, Cholis Abrori, and Komang Yunita Wiryaning Putri, “Effectivity of Pyridoxine as Adjuvant Therapy of Phenytoin in Patients with Epilepsy at Soebandi Regional Hospital Jember,” Jember Med. J., vol. 1, no. 1, pp. 29–38, 2022.
- B. F. M. Wijnen et al., “A systematic review of economic evaluations of treatments for patients with epilepsy,” Epilepsia, vol. 58, no. 5, pp. 706–726, 2017.
- A. Safdar and F. Ismail, “A comprehensive review on pharmacological applications and drug-induced toxicity of valproic acid,” Saudi Pharm. J., vol. 31, no. 2, pp. 265–278, 2023.
- L. Piccenna et al., “Management of epilepsy in older adults: A critical review by the ILAE Task Force on Epilepsy in the elderly,” Epilepsia, vol. 64, no. 3, pp. 567–585, 2023.
- E. M. Sarhan, M. C. Walker, and C. Selai, “Evidence for Efficacy of Combination of Antiepileptic Drugs in Treatment of Epilepsy,” J. Neurol. Res., vol. 5, no. 6, pp. 267–276, 2015.
- I. Kacirova, M. Grundmann, and H. Brozmanova, “Therapeutic monitoring of carbamazepine and its active metabolite during the 1st postnatal month: Influence of drug interactions,” Biomed. Pharmacother., vol. 137, no. February, 2021.
- J. Zhao, Y. Sang, Y. Zhang, D. Zhang, J. Chen, and X. Liu, “Efficacy of levetiracetam combined with sodium valproate on pediatric epilepsy and its effect on serum miR-106b in children,” Exp. Ther. Med., pp. 4436–4442, 2019.
- M. D. Lyttle et al., “Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial,” Lancet, vol. 393, no. 10186, pp. 2125–2134, 2019.
- S. Popkirov et al., “The aetiology of psychogenic non-epileptic seizures: risk factors and comorbidities,” Epileptic Disord., vol. 21, no. 6, pp. 529–547, 2019.
- Z. Kuzman, I. Mlinarevic-Polic, I. Aleric, D. Katalinic, A. Vcev, and D. Babic, “Clinical evaluation of psychiatric and behavioral disorders in adolescents with epilepsy: a cross-sectional study,” Nord. J. Psychiatry, vol. 74, no. 5, pp. 352–358, 2020.
- C. Croitoru, S. Turliuc, and R. Ioana, “From epilepsy to schizoform organic delusional disorder – a case report of chronic interictal psychosis,” no. October, 2017.
- M. B. Wubie, M. N. Alebachew, and A. B. Yigzaw, “Common mental disorders and its determinants among epileptic patients at an outpatient epileptic clinic in Felegehiwot Referral Hospital, Bahirdar, Ethiopia: Cross-sectional study,” Int. J. Ment. Health Syst., vol. 13, no. 1, pp. 1–10, 2019.
- P. Spindler, K. Bohlmann, H. B. Straub, P. Vajkoczy, and U. C. Schneider, “Effects of vagus nerve stimulation on symptoms of depression in patients with difficult-to-treat epilepsy,” Seizure, vol. 69, no. April, pp. 77–79, 2019.
- J. S. Medel-Matus, S. Orozco-Suárez, and R. G. Escalante, “Factors not considered in the study of drug-resistant epilepsy: Psychiatric comorbidities, age, and gender,” Epilepsia Open, vol. 7, no. S1, pp. S81–S93, 2022.
- K. N. Fatmi, D. Roshinta, L. Dewi, and M. In’am Ilmiawan, “The Relation of Duration of Epilepsy, Seizure Frequency and AED Adherence With Cognitive Function in Epilepsy Patients,” J. Nas. Ilmu Kesehat. , vol. 4, no. 2621–6507, p. 52, 2022.
- A. Schorner and R. Weissert, “Patients with epileptic seizures and multiple sclerosis in a multiple sclerosis center in Southern Germany between 2003-2015,” Front. Neurol., vol. 10, no. JUN, pp. 1–8, 2019.
- A. Beydoun, S. DuPont, D. Zhou, M. Matta, V. Nagire, and L. Lagae, “Current role of carbamazepine and oxcarbazepine in the management of epilepsy,” Seizure, vol. 83, no. September, pp. 251–263, 2020.
- A. P. Hamad, T. Ferrari-Marinho, L. O. Caboclo, U. Thomé, and R. M. F. Fernandes, “Nonconvulsive status epilepticus in epileptic encephalopathies in childhood,” Seizure, vol. 80, no. June, pp. 212–220, 2020.