Jesso George1, Chanda Kulkarni2, G R K Sarma3. 1. Division of Clinical Pharmacology. 2. Division of Clinical Pharmacology. Electronic address: drchandakulkarni@gmail.com. 3. Department of Neurology, St. John's Medical College, Bangalore, India.
Abstract
OBJECTIVES: The present study evaluated patterns of the use of antiepileptic drugs (AEDs) and their impact on quality of life (QOL) in patients with epilepsy. METHODS: In this cross-sectional study, patients with epilepsy (age >18 years) receiving AEDs for at least 1 year were enrolled. Demographic, clinical, and treatment parameters were recorded. QOL was measured using the modified Quality of Life in Epilepsy Inventory-10 (QOLIE-10) questionnaire for epilepsy. RESULTS: Of 200 patients, 53.5% were males and 60% were younger than 30 years. Seizures were predominantly partial (58%) and of idiopathic origin (61%). Monotherapy to polytherapy ratio was 1:1, with 70% of the patients on one new AED. Clobazam (37%) was used most frequently followed by phenytoin (25.5%), levetiracetam (23%), oxcarbazepine (21.5%), and carbamazepine (21%). Patients on polytherapy experienced a significantly more number of adverse drug reactions than did those on monotherapy (P < 0.0001). The mean QOLIE-10 score was 74.58 ± 20.60. There was no significant difference in seizure frequency, number of adverse drug reactions, and QOLIE-10 score among patients receiving old and new AEDs. Multiple linear regression analysis identified increased seizure frequency (standardized β -0.157; P = 0.003), more number of AEDs (standardized β 0.107; P = 0.05) as well as adverse drug reactions (standardized β -0.692; P = 0.0001) as significant predictors of poor QOL. CONCLUSIONS: Appropriate tools for early detection, selection of rational and safer AED treatment options, and regular monitoring for adverse effects play a crucial role in achieving seizure freedom and optimal QOL in patients with epilepsy.
OBJECTIVES: The present study evaluated patterns of the use of antiepileptic drugs (AEDs) and their impact on quality of life (QOL) in patients with epilepsy. METHODS: In this cross-sectional study, patients with epilepsy (age >18 years) receiving AEDs for at least 1 year were enrolled. Demographic, clinical, and treatment parameters were recorded. QOL was measured using the modified Quality of Life in Epilepsy Inventory-10 (QOLIE-10) questionnaire for epilepsy. RESULTS: Of 200 patients, 53.5% were males and 60% were younger than 30 years. Seizures were predominantly partial (58%) and of idiopathic origin (61%). Monotherapy to polytherapy ratio was 1:1, with 70% of the patients on one new AED. Clobazam (37%) was used most frequently followed by phenytoin (25.5%), levetiracetam (23%), oxcarbazepine (21.5%), and carbamazepine (21%). Patients on polytherapy experienced a significantly more number of adverse drug reactions than did those on monotherapy (P < 0.0001). The mean QOLIE-10 score was 74.58 ± 20.60. There was no significant difference in seizure frequency, number of adverse drug reactions, and QOLIE-10 score among patients receiving old and new AEDs. Multiple linear regression analysis identified increased seizure frequency (standardized β -0.157; P = 0.003), more number of AEDs (standardized β 0.107; P = 0.05) as well as adverse drug reactions (standardized β -0.692; P = 0.0001) as significant predictors of poor QOL. CONCLUSIONS: Appropriate tools for early detection, selection of rational and safer AED treatment options, and regular monitoring for adverse effects play a crucial role in achieving seizure freedom and optimal QOL in patients with epilepsy.
Authors: Pabitra Hriday Patra; Melissa Barker-Haliski; H Steve White; Benjamin J Whalley; Sarah Glyn; Haramrit Sandhu; Nicholas Jones; Michael Bazelot; Claire M Williams; Alister James McNeish Journal: Epilepsia Date: 2018-12-26 Impact factor: 5.864
Authors: Linda Kalilani; Edward Faught; Hyunmi Kim; Chakkarin Burudpakdee; Arpamas Seetasith; Scott Laranjo; David Friesen; Kathrin Haeffs; Victor Kiri; David J Thurman Journal: Neurology Date: 2019-04-10 Impact factor: 9.910