Sudden unexplained death among subjects with refractory epilepsy.
OBJECTIVE
To address concerns about possible increases in rates of sudden unexplained death (SUD) after use of new anticonvulsants, more information on the rate of SUD among subjects with refractory epilepsy is needed to provide a comparison.


METHODS
We conducted a study to estimate the incidence of SUD among subjects younger than 50 years with refractory epilepsy, by using information from the General Practice Research Database (GPRD) in the United Kingdom. For the purposes of this study, subjects receiving two or more anticonvulsant drugs concurrently were considered to have refractory epilepsy. Potential cases of SUD were identified from the computer records, and clinical records for these subjects were reviewed by two specialists in SUD in epilepsy.


RESULTS
Fifteen subjects (eight male, seven female) of the 4,150 subjects with refractory epilepsy were considered to have definite/probable or possible SUD.


CONCLUSIONS
The overall incidence rate of SUD in the population was 2.2 per 1,000 person-years (95% CI, 1.3-3.6). The rate for subjects with highly probable SUD was 1.5 per 1,000 person-years (95% CI, 0.8-2.7).
Derby
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Boston Collaborative Drug Surveillance Program, Boston University Medical Center, Lexington, Massachusetts, MA 02173, USA.
Tennis
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Jick
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D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D016001:Confidence Intervals; D016208:Databases, Factual / Q000706:statistics & numerical data; D003645:Death, Sudden / Q000453:epidemiology*; D004827:Epilepsy / Q000188:drug therapy / Q000401:mortality*; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology
D000927:Anticonvulsants