Differing Physician Perceptions of Oxcarbazepine and Levetiracetam for Women of Child- Bearing Age: A Physician Survey Based Study

Abstract

Background: Young women of reproductive age constitute a significant proportion of India's epilepsy patient population. Doctors take several considerations into account while prescribing antiepileptic drugs (AEDs) to young women to balance the risk of seizures with other concerns. Objective: To understand how doctors perceive various AEDs regarding their safety, efficacy, and other attributes for women of childbearing age. Materials and Methods: This study consisted of a survey designed to understand the usage and perception of 12 antiepileptic drugs in the Indian market. The survey respondents of this study were neurologists, neurosurgeons, and psychiatrists from all over India, from private or government setups, and with different experience and patient load levels. Results: In the study, 93% of all survey respondents indicated that they avoid one or more AEDs in women of childbearing age, making it a significant consideration. This consideration is a specialty split for the second- generation AEDs, Oxcarbazepine, and Levetiracetam. Approximately three times more Neurosurgeons avoid Oxcarbazepine as compared to neurologists and psychiatrists who use this drug. In the case of Levetiracetam, mainly only psychiatrists avoid it for women of reproductive age. Apart from the personal experience of doctors, factors other than teratogenic risks, such as changes in reproductive hormone levels, may have contributed to the observed difference in perception. Conclusion: The study highlights doctors ‘differing perceptions for highly used drugs among all specialties emphasizing the need to determine if such differences in perception exist between other AEDs for various types of patient profiles.