Drug treatment in patients with newly diagnosed unprovoked seizures/epilepsy.
OBJECTIVE
The objective of this study was to analyze drug treatment in patients with newly diagnosed unprovoked seizures/epilepsy in a population-based cohort in Stockholm, Sweden.


METHODS
Clinical data from the Stockholm Incidence Registry of Epilepsy was cross-linked with drug dispensing data from the Swedish Prescribed Drug Register to analyze drug treatment in patients diagnosed with unprovoked seizures between 2006 and 2008. Specific questions addressed were the use of other medications at seizures onset, the proportion of patients initiated on different antiepileptic drugs (AEDs) within one year after inclusion, and the extent of switching between different AEDs during the first year.


RESULTS
In total 367 patients were included. More than 50% had other medications prescribed at date of first seizure. All together, 262 patients received an AED within one year and 257 patients (98%) were initiated on monotherapy. One year after first prescription, 147 patients (56%) remained on the initially prescribed AED and 48 patients (18%) had switched to another AED. Among the remaining patients, 29 (11%) had died and 38 patients (15%) had discontinued AED treatment.


CONCLUSIONS
A majority of all patients with epilepsy receive treatment within one year. Many patients use other medications and several of them are related to known comorbidities and can also be involved in drug-drug interactions. Nevertheless, most patients remained on the same AED at the end of the first year.
Public Healthcare Services Committee Administration, Box 17533, SE-118 91 Stockholm, Sweden. Electronic address: linnea.e.karlsson@sll.se.
Linnéa
L
Karlsson
Public Healthcare Services Committee Administration, Box 17533, SE-118 91 Stockholm, Sweden; Karolinska University Hospital Solna, Centre for Pharmacoepidemiology, SE-171 76 Stockholm, Sweden. Electronic address: bjorn.wettermark@sll.se.
Björn
B
Wettermark
Karolinska Institutet, Department of Clinical Neurosciences, SE-171 77 Stockholm, Sweden. Electronic address: torbjorn.tomson@karolinska.se.
Torbjörn
T
Tomson
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004363:Drug Utilization; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012042:Registries; D012640:Seizures / Q000188:drug therapy* / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
D000927:Anticonvulsants
Antiepileptic drugs; Drug utilization; Epilepsy; Prescribing; Seizures