title: Changing trends in antiepileptic drug prescribing in girls of child-bearing potential.
abstract: OBJECTIVE
  To characterize trends in prescribing carbamazepine (CBZ), sodium valproate (VPA) and lamotrigine (LTG) in adolescent females in the UK and to examine possible reasons for changing trends.
  
  
  METHODS
  Population-based observational study.
  
  
  METHODS
  UK General Practice Research Database between 1 January 1993 and 31 December 2006.
  
  
  METHODS
  12-18-year-old subjects who were issued >or=1 CBZ, VPA or LTG prescription.
  
  
  METHODS
  Prescribing prevalences stratified by age, gender and antiepileptic drug.
  
  
  RESULTS
  5417 patients (47.6% females) were prescribed 147 111 prescriptions for CBZ (34.5%), VPA (38.6%) or LTG (26.9%). The prevalence of LTG prescribing in females increased from 0.08 (95% CI 0.04 to 0.12) to 0.80 (95% CI 0.70 to 0.89) per 1000 female population. Conversely, the prevalence in females of CBZ and VPA prescribing significantly decreased from 1.00 (95% CI 0.85 to 1.15) to 0.51 (95% CI 0.44 to 0.58) and from 0.94 (95% CI 0.80 to 1.09) to 0.63 (95% CI 0.55 to 0.72), respectively. This 10-fold rise in LTG prescribing in females is much higher than the fivefold rise in males from 0.09 (95% CI 0.05 to 0.14) to 0.47 (95% CI 0.40 to 0.54) per 1000 male population.
  
  
  CONCLUSIONS
  The practice of prescribing antiepileptic drugs in adolescents has changed gradually over the last decade. More females aged 12-18 years are prescribed LTG than CBZ or VPA and the increase is much greater than for males. The increase in LTG prescribing mirrors a corresponding decrease in both VPA and CBZ. Concerns about potential problems to offspring appear to be affecting prescription trends in adolescent females of child-bearing potential.
authors.affiliation: Centre for Paediatric Pharmacy Research, School of Pharmacy, University of London, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Ackers
authors.forename: F M C
authors.initials: FM
authors.lastname: Besag
authors.forename: A
authors.initials: A
authors.lastname: Wade
authors.forename: M L
authors.initials: ML
authors.lastname: Murray
authors.forename: I C K
authors.initials: IC
authors.lastname: Wong
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000517:prevention & control; D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002220:Carbamazepine / Q000627:therapeutic use; D002648:Child; D003270:Contraceptive Agents / Q000008:administration & dosage; D004347:Drug Interactions; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D010818:Practice Patterns, Physicians' / Q000639:trends; D011247:Pregnancy; D014227:Triazines / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D003270:Contraceptive Agents; D014227:Triazines; D002220:Carbamazepine; D014635:Valproic Acid; D000077213:Lamotrigine