[Use of antiepileptic drugs in nursing home residents].
BACKGROUND
Epilepsy is prevalent in elderly above 65 years of age, and treating epileptic seizures in this age group may be challenging. The aim of this study was to establish the prevalence of epilepsy and the use of antiepileptic drugs in nursing homes in two counties close to Oslo.


METHODS
The two counties Asker and Baerum have 155,000 inhabitants and 19 nursing homes. The prescription charts of 1053 nursing home residents were examined in January 2005; for those who used antiepileptic drugs the medical records were also examined.


RESULTS
116 of the 1053 residents (11%) used antiepileptic drugs; 83 of the 116 (72%) due to epilepsy. 17 residents used antiepileptic drugs against pain, and 14 as psychotropic drugs. 92 residents (79%) were using antiepileptic drugs on a regular basis; 77 used one antiepileptic drug, 14 residents used two such drugs and one resident used four antiepileptic drugs. In 77% of the prescriptions, older antiepileptic drugs were prescribed, and slow-release formulations were seldom used. 24 of the residents reported side effects caused by antiepileptic drugs; sedation and dizziness being the most common. The last year, therapeutic drug monitoring was performed in 42%. Average number of drugs used, including antiepileptic drugs, was seven (range 1-16). In the epilepsy population 69 (83%) had a symptomatic, localization-related epilepsy. Cerebrovascular disease was the cause of epilepsy in 44 patients (53%).


CONCLUSIONS
Antiepileptic drug treatment and care for nursing home residents with epilepsy are suboptimal and could be improved.
Rytter
Elisif
E
Spesialsykehuset for epilepsi, Nevroklinikken Rikshospitalet-Radiumhospitalet, Postboks 53, 1306 Baerum postterminal. elisif.rytter@epilepsy.no
Nakken
Karl O
KO
Mørch-Reiersen
Lisa T
LT
Efjestad
Anne
A
Selvig
Kirsten
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D019338:Polypharmacy
D000927:Anticonvulsants