title: Trends in the first antiepileptic drug prescribed for epilepsy between 2000 and 2010.
abstract: OBJECTIVE
  To investigate changes in the choice of first anti-epileptic drug (AED) and co-prescription of folic acid after a new diagnosis of epilepsy.
  
  
  METHODS
  We searched anonymised electronic primary care records dating between 2000 and 2010 for patients with a new diagnosis of epilepsy and recorded the first AED prescribed and whether folic acid was co-prescribed.
  
  
  RESULTS
  From 13.3 million patient years of primary care records, we identified 3714 patients with a new diagnosis of epilepsy (925 children and 649 women aged 14-45 years). Comparing first time AED prescriptions in 2000 and 2001 to those in 2009 and 2010 showed a significant decrease in the proportion of carbamazepine and phenytoin prescribed and a significant increase in the proportion of lamotrigine and levetiracetam prescribed. In women aged 14-45 years, and girls aged <18 there was a significant decrease in the proportion of sodium valproate prescribed. Women aged 14-45 years were significantly more likely to be co-prescribed folic acid with their first AED compared to all other patients (20% vs 3%, p-value<0.001). The proportion of folic acid co-prescribed with the first AED did not change significantly between 2000 and 2010.
  
  
  CONCLUSIONS
  The changing trends in the first AED prescribed over the last decade, particularly in women of childbearing age, reflect published evidence in terms of AED efficacy, tolerability and safety.
authors.affiliation: Neurology and Molecular Neuroscience Research Group, Institute of Life Science, College of Medicine, Swansea University, Swansea, UK; Wales Epilepsy Research Network (WERN), Institute of Life Science, Swansea University, Swansea, UK. Electronic address: w.o.pickrell@swansea.ac.uk.
authors.forename: W Owen
authors.initials: WO
authors.lastname: Pickrell
authors.affiliation: Wales Epilepsy Research Network (WERN), Institute of Life Science, Swansea University, Swansea, UK; Health Informatics Research Unit (HIRU), Institute of Life Science, Swansea University, Swansea, UK.
authors.forename: Arron S
authors.initials: AS
authors.lastname: Lacey
authors.affiliation: Neurology and Molecular Neuroscience Research Group, Institute of Life Science, College of Medicine, Swansea University, Swansea, UK; Wales Epilepsy Research Network (WERN), Institute of Life Science, Swansea University, Swansea, UK.
authors.forename: Rhys H
authors.initials: RH
authors.lastname: Thomas
authors.affiliation: Health Informatics Research Unit (HIRU), Institute of Life Science, Swansea University, Swansea, UK.
authors.forename: Ronan A
authors.initials: RA
authors.lastname: Lyons
authors.affiliation: Wales Epilepsy Research Network (WERN), Institute of Life Science, Swansea University, Swansea, UK; Neurology Department, University Hospital Wales, Cardiff, UK.
authors.forename: Phil E M
authors.initials: PE
authors.lastname: Smith
authors.affiliation: Neurology and Molecular Neuroscience Research Group, Institute of Life Science, College of Medicine, Swansea University, Swansea, UK; Wales Epilepsy Research Network (WERN), Institute of Life Science, Swansea University, Swansea, UK.
authors.forename: Mark I
authors.initials: MI
authors.lastname: Rees
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D011307:Drug Prescriptions; D057286:Electronic Health Records / Q000639:trends*; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic drugs; Drug utilisation; Epilepsy; Folic acid; Women