Observational Study of Prescribing Pattern of Antiepileptic Drugs in Tertiary Care Hospital

Trial Design: Observational study Methods Inclusion criteria: All In-patients who were treated with AEDs admitted in different units of Medicine Department. Exclusion Criteria: All pregnant women who are on AEDs. Sample size: 35 Objective: The chief objective behind this project was to observe the various therapy of AED used in epilepsy and in some co-morbid condition and to observe the patient condition. Outcome  A total of 35 patients data were recorded in the study for 1 month.  In the study percentage of men suffering from epilepsy was 45.71% (16) and Female was 54.24 %( 19).  The study shows that most of the patients 14 (40%) were from the age group of 31-60 years; followed by 14 (40%) of patients in the age group of 61-90 years and 7 (20%) patients were in the group of 10-30 year.  Most commonly prescribed drug concluded is phenytoin which accounts for 30 (85.30%) in both the genders, followed by phenobarbitone 11 (31.18%) and levitracetam usage was 11 (31.18%)  Monotherapy is the type of therapy most frequently used in 23 patients (65.71%).  Dual therapy is used in 6 patient (17.14%).Triple therapy is used in 5 patient (14.28%). Conclusion: The most frequently prescribed AED in the study was Phenytoin followed by Phenobarbital and levitracetam. I. Introduction Epilepsy (from the Ancient Greek ἐπιληψία (epilēpsia) —to seize”) is a common chronic neurological disorder characterized by recurrent unprovoked seizures. Epilepsy is believed to affect 1% to 2% of the population; approximately 2 million people have been diagnosed with epilepsy. The incidence is highest in childhood and old age. The prognosis is good if the patient adheres strictly to prescribed treatment. Antiepileptic drug therapy is the mainstay of treatment for most patients with epilepsy. Seizure classification is an important element in designing the treatment plan, since some antiepileptic drugs have different activities against various seizure types. The International League Against Epilepsy classify the three main types of seizures: partial, generalized, and unclassified. Amongst the various factors affecting anti-epileptic drug (AED) usage, the major determinants are type of epilepsy, age and gender of patient, side effect profile and availability of medicines, affordability of the patient, and preference of the treating physician as well as the practice setting. Attempt to control epilepsy is done using mono and poly therapy. Due to the long duration of treatment, various adverse reactions (ADRs) are seen, which require change of medication and monitoring.A recent study in Bangalore, India, reported that the problem is nearly two and half times higher in rural areas as compared to urban areas, where they are not receiving any treatment. Begin with monotherapy about 50% to 70% of patients can be maintained on one antiepileptic drug (AED), but all are not seizure free.Up to 60% of patients with epilepsy are noncompliant, and this is the most common reason for treatment failure.Drug therapy may not be indicated in patients who have had only one seizure or those whose seizures have minimal impact on their lives. Patients who have had two or more seizures should generally be started on AEDs. Factors favoring successful withdrawal of AEDs include a seizure-free period of 2 to 4 years, complete seizure control within 1 year of onset, an onset of seizures after age 2 years and before age 35 years, and a normal EEG. Many controlled clinical trials have tested the efficacy of the older Anti-Epileptic Drugs (AEDs), (such as Phenobarbital and Phenytoin) and newer AEDs (such as Carbamazepine and Valproic acid) in controlling seizure frequency and their safety when prescribed in monotherapy or in combination.