A cross-sectional study of subjective complaints in patients with epilepsy who seem to be well-controlled with anti-epileptic drugs.
OBJECTIVE
Side-effects of anti-epileptic drugs (AEDs) may be overlooked in patients with epilepsy in everyday clinical practice. The aim of this study was to assess the prevalence and severity of subjective complaints in patients who were considered to be well-controlled and to assess whether these complaints are related to medication, personality traits, or other determinants.


METHODS
We included patients with epilepsy who were considered to be well-controlled in a cross-sectional study in seven hospitals in the Netherlands. Their medication had not been changed for six months and an apparent reason to change the medication was lacking at the time of enrolment. Subjective complaints were assessed with a 46-item questionnaire. Using multivariable linear regression modeling, we assessed whether patient characteristics, epilepsy characteristics, medication, quality of life (Qolie-10), and personality traits (SCL-90) explained the presence and severity of complaints.


RESULTS
Of 173 included patients, 67% reported moderate to severe subjective complaints on the questionnaire. Cognitive complaints were reported most frequently. Multivariate modeling showed that 61% of the variance in reported complaints could be explained by included determinants. The prevalence and severity of complaints was associated with AED polytherapy and higher scores on psycho neuroticism.


CONCLUSIONS
Patients who were considered to be well-controlled proved to report an unexpectedly high number of subjective complaints. Both medication and aspects of personality contributed to the level of complaints. Our study illustrates that subjective side-effects are easily overlooked in everyday clinical practice, possibly because in practice a generally phrased question is used to detect side-effects.
Rudolf Magnus Institute of Neuroscience and University Medical Center Utrecht, Department of Clinical Neurophysiology, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. donselaar@mcrz.nl
S G
SG
Uijl
C S M P
CS
Uiterwaal
A P
AP
Aldenkamp
J A
JA
Carpay
J C
JC
Doelman
K
K
Keizer
C J
CJ
Vecht
M C
MC
de Krom
C A
CA
van Donselaar
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires
D000927:Anticonvulsants