Oun A, Haldre S, Mägi M
Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.
Eur J Neurol. 2006 May;13(5):465-70. doi: 10.1111/j.1468-1331.2006.01268.x.
An evaluation of general antiepileptic treatment patterns and utilization of particular drugs was carried out based on the prevalence study of adult active epilepsy in a sample of the Estonian population. The antiepileptic drugs (AEDs) used, and their doses were recorded and compared with clinical characteristics. Nineteen per cent of the subjects did not take any AED on the prevalence day; 83% of those on medication were taking a single drug, 15% two, and 2% three AEDs. Localization-related symptomatic epilepsies were most frequently treated with AEDs and were also the largest group receiving polytherapy. The most common agent was carbamazepine (68%), followed by barbiturates. Valproate and phenytoin were used much less. The study design and its impact on the interpretation of results is discussed. The percentage of sodium-channel blockers is generally comparable with that reported from other European countries. The small share of valproate is probably a result of the extensive utilization of barbiturates, and is partially related to the age distribution in the study. The high figure of AED-free cases, and small percentage of polytherapy indicates a tendency for undertreatment. Some points for improvement in AED therapy are discussed.
基于爱沙尼亚人群样本中成人活动性癫痫的患病率研究，对一般抗癫痫治疗模式和特定药物的使用情况进行了评估。记录了所使用的抗癫痫药物（AEDs）及其剂量，并与临床特征进行比较。在患病率调查当天，19%的受试者未服用任何AEDs；服药者中83%服用单一药物，15%服用两种，2%服用三种AEDs。与定位相关的症状性癫痫最常使用AEDs治疗，也是接受联合治疗的最大群体。最常用的药物是卡马西平（68%），其次是巴比妥类药物。丙戊酸盐和苯妥英钠的使用较少。讨论了研究设计及其对结果解释的影响。钠通道阻滞剂的比例总体上与其他欧洲国家报告的比例相当。丙戊酸盐使用比例低可能是巴比妥类药物广泛使用的结果，部分与研究中的年龄分布有关。未使用AEDs病例的比例高以及联合治疗的比例低表明存在治疗不足的趋势。讨论了AED治疗中一些需要改进的地方。
