title: Drug treatment-related factors of inadequate seizure control.
abstract: To optimize seizure control it is important to identify modifiable factors. We conducted a case-control study to explore to what extent drug treatment-related factors are associated with seizures. Eighty-six patients with epilepsy were evaluated: 45 cases (recently experienced a seizure) and 41 controls (seizure-free for at least 2 months). There was a significant association between low AED serum concentration and seizures (odds ratio (OR)=8.9, 95% confidence interval (CI)=1.7-47.8), compliance was not associated with seizures (OR=0.9, 95% CI=0.2-4.0), and changes in medication (mainly non-AEDs) were more frequently observed in the case group than in the control group (OR=4.1, 95% CI=0.9-18.3). These findings indicate that patients with low AED serum levels have a nine times higher risk of seizures compared with patients with therapeutic AED levels and that changes in medication regimens in patients with epilepsy should be made with care.
authors.affiliation: Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, The Netherlands.
authors.forename: Kim B
authors.initials: KB
authors.lastname: Handoko
authors.forename: Jeannette E F
authors.initials: JE
authors.lastname: Zwart-van Rijkom
authors.forename: Huib F
authors.initials: HF
authors.lastname: Visee
authors.forename: Walter A J J
authors.initials: WA
authors.lastname: Hermens
authors.forename: Yechiel A
authors.initials: YA
authors.lastname: Hekster
authors.forename: Toine C G
authors.initials: TC
authors.lastname: Egberts
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000097:blood / Q000627:therapeutic use*; D016022:Case-Control Studies; D003187:Compliance / Q000502:physiology*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000097:blood / Q000188:drug therapy* / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants