Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
The Health and Medical Care Administration, Stockholm County Council, Stockholm, Sweden.
Basic Clin Pharmacol Toxicol. 2018 Jul;123(1):94-100. doi: 10.1111/bcpt.12981. Epub 2018 Mar 30.
This study aimed to investigate the utilization of antiepileptic drugs (AEDs) in children and adolescents with epilepsy and other diagnoses in a nationwide population between 2007 and 2014. Data on dispensed prescriptions of AEDs were collected from the Swedish Prescribed Drug Register and linked to diagnosis data from the National Patient Register covering all in- and outpatient consultations from Swedish hospitals. Children aged 0-17 years who had received at least one prescription for AEDs were selected. We calculated proportions of patients stratified by indication, sex and type of AED. A total of 18,131 patients (mean age 9.5 years, 50% boys) were initiated on AED treatment between January 2007 and December 2014. Epilepsy was the most frequent diagnosis (46%) recorded within the year prior to the first AED dispensing. Psychiatric and pain diagnoses were more common in girls (sex distribution 70/30 and 59/41, respectively). In epilepsy, the most frequently initiated AED was valproic acid in boys and lamotrigine in girls. Lamotrigine was the most frequently initiated drug in psychiatry, in both boys and girls. This nationwide study provides new knowledge on AED use in children and adolescents. The use of AEDs during the study period was mainly restricted to epilepsy, and the individual AEDs used seems to be in accordance with approved indications. However, the use of AED on non-epilepsy diagnoses, especially pain disorders, raises concerns.
本研究旨在调查 2007 年至 2014 年间全国范围内儿童和青少年癫痫及其他诊断患者抗癫痫药物（AED）的使用情况。AED 处方数据来自瑞典处方药物登记处，与国家患者登记处的诊断数据相关联，该登记处涵盖了所有瑞典医院的门诊和住院咨询。选择了至少接受过一次 AED 处方的 0-17 岁儿童。我们按适应证、性别和 AED 类型对患者进行分层，计算了患者的比例。2007 年 1 月至 2014 年 12 月期间，共有 18131 名患者（平均年龄 9.5 岁，50%为男性）开始接受 AED 治疗。在开始首次 AED 配药前一年，癫痫是最常见的诊断（46%）。精神科和疼痛诊断在女孩中更为常见（性别分布分别为 70/30 和 59/41）。在癫痫患者中，男孩中最常起始的 AED 是丙戊酸，女孩中最常起始的是拉莫三嗪。拉莫三嗪是精神科中男女最常起始的药物。这项全国性研究提供了儿童和青少年 AED 使用的新知识。研究期间 AED 的使用主要限于癫痫，使用的个别 AED 似乎符合批准的适应证。然而，在非癫痫诊断（尤其是疼痛障碍）中使用 AED 引起了关注。
