An audit of lamotrigine, levetiracetam and topiramate usage for epilepsy in a district general hospital.
The aim of this audit was to ascertain outcomes for people who had taken or who were still taking three "new generation" broad-spectrum antiepileptic drugs (AEDs), namely lamotrigine, levetiracetam and topiramate. Thirteen percent of people became seizure free and approximately, one-third had a reduction of greater than 50% in their seizures. Two-thirds of people were still taking their audit AED. In addition, approximately one-third of people with a learning disability derived substantial benefit, although the rate of seizure freedom was lower. All three AEDs were most successful at treating primary generalised epilepsy and least successful with symptomatic generalised epilepsy. With some reservations the data suggests that levetiracetam and topiramate are the most efficacious AEDs, but topiramate is the least well tolerated. These results mean consideration of a "general prescribing policy" is important when using and choosing these AEDs. We conclude that lamotrigine, levetiracetam and topiramate are useful additions to the armamentarium of AEDs.
Chappell
Brian
B
Department of Neurosciences, York District Hospital, Wigginton Road, York YO31 8HE, UK. neuroeducation@ntlworld.com
Crawford
Pamela
P
D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D015331:Cohort Studies; D004363:Drug Utilization; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D004829:Epilepsy, Generalized / Q000188:drug therapy; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006801:Humans; D051188:Knowledge Bases; D000077213:Lamotrigine; D007859:Learning Disabilities / Q000150:complications; D000077287:Levetiracetam; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010352:Patient Dropouts; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077236:Topiramate; D014227:Triazines / Q000627:therapeutic use*; D006113:United Kingdom
D000927:Anticonvulsants; D014227:Triazines; D000077236:Topiramate; D005632:Fructose; D000077287:Levetiracetam; D000077213:Lamotrigine; D010889:Piracetam