title: Prescription patterns of antiepileptic drugs in young women: development of a tool to distinguish between epilepsy and psychiatric disorders.
abstract: Antiepileptic drugs (AEDs) are also prescribed for therapeutic indications other than epilepsy (EPI), namely, psychiatric disorders (PSY). Our aim was to develop an algorithm able to distinguish between EPI and PSY among childbearing age women based on differences in AED exposure in these patient groups.
  
  
  
  Two groups of women (18-45 years) with EPI or PSY treated with AEDs in the first semester of 2010 or 2011 were extracted from paper or electronic medical charts of specialized centers. Through the prescription database of Bologna Local Health Authority (Italy), AEDs, treatment schedule and co-treatments were collected for each patient. A prescription-based hierarchical classification system was developed. The algorithm obtained was subsequently validated on internal and external data.
  
  
  
  Eighty-one EPI and 94 PSY subjects were recruited. AED monotherapy was the most common choice in both groups (69% EPI vs 79% PSY). Some AEDs were used only in EPI, others exclusively in PSY. Co-treatments with antipsychotics (6% vs 67%), lithium (0% vs 9%), and antidepressants (7% vs 70%) were fewer in EPI than in PSY. The hierarchical classification system identified antipsychotics, SSRIs (Selective Serotonin Reuptake Inhibitors), and number of AEDs as variables to discriminate EPI and PSY, with an overall error rate estimate of 9.7% (95%CI: 5.3% to 14.1%).
  
  
  
  Among the differences between EPI and PSY, prescription data alone allowed an algorithm to be developed to diagnose each childbearing age woman receiving AEDs. This approach will be useful to stratify patients for risk estimates of AED-treated patients based on administrative databases. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Naldi
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Piccinni
authors.affiliation: IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Mostacci
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Jessica
authors.initials: J
authors.lastname: Renzini
authors.affiliation: IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Accetta
authors.affiliation: IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy.|Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bisulli
authors.affiliation: IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Tappatà
authors.affiliation: Mental Health Department, Bologna Local Health Authority, Bologna, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Piazza
authors.affiliation: Pharmaceutical Department, Bologna Local Health Authority, Bologna, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Pagano
authors.affiliation: Pharmaceutical Department, University Hospital of Ferrara, Ferrara, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bianchi
authors.affiliation: IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: D'Alessandro
authors.affiliation: IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy.|Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Tinuper
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Poluzzi
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000008:administration & dosage; D014150:Antipsychotic Agents / Q000008:administration & dosage; D016208:Databases, Factual; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007558:Italy; D018020:Lithium Compounds / Q000008:administration & dosage; D001523:Mental Disorders / Q000188:drug therapy*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D018020:Lithium Compounds
keywords: antiepileptic drugs; childbearing age; epilepsy; pharmacoepidemiology; prescription patterns; psychiatric disorders; women