A study of Rationale use of Sodium valproate and Levetiracetam as monotherapy in pediatric patients with Epilepsy at tertiary care hospital

Abstract

Background: Drug utilization studies helps in the understanding of drug usage among patients, as well as the socioeconomic background and rational use of antiepileptics in children with epilepsy.
 
 Objective: The primary aim of this article is to examine the justification for utilizing sodium valproate and Levetiracetam as monotherapy in pediatric epilepsy patients, as well as drug use and prescribing patterns for various kinds of epilepsy.
 Materials & Methods:
 Pediatric epilepsy patients under the age of 18 who visited the outpatient department, patients who were on sodium valproate, carbamazepine, or Levetiracetam monotherapy for at least 3 months after starting treatment. Demographic details, disease characteristics like type of epilepsy, onset and duration of episode, details of first attack, last attack, frequency and family history related to epilepsy comorbid conditions. Details on the treatment, such as the drug prescribed, the dose, the duration of the treatment, and the dosage, were noted. Magnetic resonance image (MRI) Brain, CT Brain, Electroencephalogram (EEG) was done in selected patients and noted. 
 Results:
 In this study we have total of 91 patients younger than 18 years of age confirmed with epilepsy receiving Sodium valproate, Levetiracetam as Monotherapy. Among them 70.3% were male and 29.6% were females. As per the recent Kuppuswamy scale 64.8% of the patients were from an urban background, whereas 35.1% were from a rural background. On analyzing socioeconomic status we found that 38.5% belong to upper middle class family. Nearly 26 % of the patients were diagnosed with focal seizures and 25% with GTCS. Lesser percentage observed with Rolandic, myoclonic, complex partial, refractory epilepsy. Majority 53.8 % were on Sodium valproate among older AEDs. Among newer AEDs 29.6% of patients received Levetiracetam as monotherapy.
 Key words:
 Epilepsy, Sodium valproate, Levetiracetam, Monotherapy, Rational use