Medication use, self-reported drug allergies, and estimated medication cost in patients with epileptic versus nonepileptic seizures

Abstract

The decision to take medication may say as much about a patient’s self-perception as it does about his or her diagnosis. Patient-reported drug allergies often cannot be verified by physicians, and may be a self-perception not always grounded in medical reality. We retrospectively studied medication use and self-reported drug allergies in 346 sequential epilepsy monitoring unit (EMU) inpatients from 1994–96. Because financial concerns play an increasing role in patient care, we also estimated minimum antiepileptic drug (AED) costs. A clear diagnosis was reached in 226/346 (65%) cases. Seventy-four cases were nonepileptic seizures (NES) (33%) and 152 were epileptic seizures (ES) (67%). The NES patients were significantly more likely to be women (76%) than were ES patients (60%) ( p < 0.01). The NES and ES patients took an average of 3.6 and 3.3 medications, respectively, at baseline ( p > 0.05). The ES patients took more AEDs than NES patients [1.9 and 1.3, respectively ( p < 0.01)]. Conversely, NES patients took more non-AEDs at baseline [2.3 vs. 1.4 ( p < 0.01)]. The NES patients reported more drug allergies than did ES patients [1.1 vs. 0.8 ( p < 0.05)]. Minimum average estimated AED costs for NES patients were $70.04 per month, and for ES patients were $104.22. The tendency to take more medicines and reported more drug allergies by NES patients may reflect a greater tendency to manifest psychologic distress as physical symptoms. This comes at a high cost, with minimum estimated cost of $70 per month.