Vol. 8, Issue 5 (2019)

Background: Anti-epileptic drugs (AEDs) are commonly used throughout the world. This is because they are mainly used to treat epilepsy which is one of the most neurological disorders all over the world. Anti-epileptic drugs are classified into older generation and newer generation drugs. The older generation drugs include phenytoin, phenobarbital, valproic acid, ethosuximide and carbamazepine. The newer generation drugs include felbamate, gabapentin, lamotrigine, topiramate, zonisamide, tiagabine, oxcarbazepine, pregabalin, levetiracetam, rufinamide, lacosamide, vigabatrin, clobazam, ezogabine, perampanel and eslicarbazepine acetate.

Objectives: To analyze the usage of anti-epileptic drugs, the cost of treatment, to find out any drug related issues with the treatment given (drug induced seizures, pregnancy, interactions, side effects or adverse effects, drug safety and effect of drug) and to study the effect of the old and newer anti-epileptic drugs in terms of effect, side effects, adverse drug reactions (ADRs.)

Methods: The study was done at the PSG Hospitals, Coimbatore from December 2017 to April 2018. Information was collected and filled in the data collection form from patient files after giving informed consent. The results were calculated using percentages.

Results: Two hundred and thirteen patients were selected. The use of older anti-epileptic drugs was present in 22 cases (10%) while 122 patients received the newer anti-epileptic drugs (57%) and those who received a combination of both were 69(32%). Levetiracetam was the most highly prescribed of all the drugs and also for the newer drugs at 126 times (33%) while phenytoin was most prescribed of the older drugs 56(15%). Seizure cases were 145(68%) non seizure cases were 68(32%). The total number of adverse drug reactions present in all the cases were 54. Older drug adverse drug reactions were fewer than newer drug adverse drug reactions at a ratio of 37% to 63% respectively. The costs of newer anti-epileptic drugs were seen to be higher than those of older generation anti-epileptic drugs. The average costs of the drugs (both injection and tablets) was found to be Phenobarbital 7.93/-, Phenytoin 32.735/-, Carbamazepine 11.62/-, Valproic acid 45.4/-, Clonazepam 84.5/-, Clobazam 66.22/-, Gabapentin 148.7/-, Pregabalin 68.7/-, Lacosamide 37.16, Lamotrigine 94.9375, Oxcarbazepine 19.06/-, Topiramate 79.33/-, Perampanel 55/-, Zonisamide 102/-, Levetiracetam 236.48/-.

Conclusion: The use of newer anti-epileptic drugs has increased greatly. Monotherapy of anti-epileptic drugs is still quite common. The costs of newer anti-epileptic drugs are quite high as compared to older anti-epileptic drugs. Overall, the newer drugs had more adverse drug reactions cases as compared to the older generation drugs.