Abstract
Among patients with epilepsy, almost 70% become seizure-free with the current antiseizure drugs (ASDs) within 20 years following seizure onset. Of those who have been seizure-free for many years, around 70% remain seizure-free after withdrawal of ASDs.The purpose of this study was to determine the extent to which seizure-free patients with epilepsy in Norway discuss drug discontinuation with their physician.An online questionnaire was used; among the respondents were 186 adult patients who had been seizure-free for at least five years and were still using ASDs. Of these, 60 patients (32%) reported that they had discussed the question of drug withdrawal with their treating physician. Those patients who reported being involved in treatment decisions were more likely to have discussed ASD withdrawal.In conclusion, it is our opinion that discontinuation of drug treatment in patients with long-term seizure freedom is discussed far too seldom and that many patients may be living with an unnecessary drug burden.
Highlights
About 65 million people suffer from epilepsy worldwide [1]
This was a collaborative study between the National Centre for Epilepsy in Norway and the Norwegian Epilepsy Association (NEA)
A total of 1172 adult patients participated in the study
Summary
About 65 million people suffer from epilepsy worldwide [1]. In Western countries, about 25 antiseizure drugs (ASDs) are currently available on the market, and following treatment with these drugs, about 70% of the patient population achieves long-term seizure freedom [2]. When a patient with epilepsy has been seizure-free for a certain period of time, discontinuation of ASD therapy may be considered. Two randomized controlled trials have been conducted to explore whether ASD withdrawal is justifiable in patients who have been seizure-free for at least two years [5,6]. These studies showed that the risk of seizure recurrence in the withdrawal group was about twice that of those who continued their drug treatment; 40% vs 20% [5,6] and 15% vs 7% [5,6].
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