Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India.
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Indian J Pharmacol. 2020 Jul-Aug;52(4):283-289. doi: 10.4103/ijp.IJP_507_17.
The present study aimed to determine the pattern of prescription of antiepileptic drugs (AEDs) in a cohort of patients with epilepsy (PWE) attending a tertiary care center of North India.
Demographic variables including age, gender, age at onset, type and frequency of seizures, and prescription of all AEDs (dose and duration) were noted. Descriptive analysis of the use of AEDs was done, and their different combinations were studied.
A total of 1187 prescriptions were evaluated. Demography showed 65.7% of males; mean age of 21.9 years (range: 2-77 years), generalized seizures (53%), and focal seizures (47%). Only 21.8% of the patients were seizure free with no seizure in 1 year of treatment. The five most frequently prescribed AEDs out of 12 AEDs were sodium valproate (VPA) (49.6%), clobazam (CLB) (39.3%), levetiracetam (LEV) (28.4%), carbamazepine (CBZ) (27.3%), and phenytoin (PHT) (26.5%). Monotherapy was effective in 36.6% of the patients. Sodium VPA (39.4%), PHT (25.6%), and CBZ (20.1%) were commonly used as monotherapy. Polytherapy was required in 63.4% of the patients, and most commonly prescribed combinations were PHT + CLB (n = 53), sodium VPA + CLB (n = 62), CBZ + CLB (n = 45), PHT + sodium VPA + CLB (n = 28), and CBZ + sodium VPA + CLB (n = 31).
Polytherapy is a very common practice in our tertiary care center. Sodium VPA, a highly prescribed AED, results in good control of generalized seizures, whereas focal seizures are well controlled by CBZ alone as well as in combination. The present study highlights the commonly prescribed combinations of AEDs resulting in control of different types of seizures.
本研究旨在确定在印度北部一家三级护理中心就诊的癫痫患者（PWE）中抗癫痫药物（AED）的处方模式。
记录人口统计学变量，包括年龄、性别、发病年龄、发作类型和频率以及所有 AED（剂量和持续时间）的处方。对 AED 的使用进行描述性分析，并研究其不同的组合。
共评估了 1187 份处方。人口统计学显示 65.7%为男性；平均年龄为 21.9 岁（范围：2-77 岁），全身性发作（53%）和局灶性发作（47%）。仅有 21.8%的患者在治疗 1 年内无癫痫发作且无癫痫发作。在 12 种 AED 中，最常开的五种 AED 是丙戊酸钠（VPA）（49.6%）、氯巴占（CLB）（39.3%）、左乙拉西坦（LEV）（28.4%）、卡马西平（CBZ）（27.3%）和苯妥英（PHT）（26.5%）。单药治疗在 36.6%的患者中有效。丙戊酸钠（39.4%）、苯妥英（25.6%）和卡马西平（20.1%）常作为单药治疗。63.4%的患者需要联合治疗，最常用的组合是苯妥英+氯巴占（n=53）、丙戊酸钠+氯巴占（n=62）、卡马西平+氯巴占（n=45）、苯妥英+丙戊酸钠+氯巴占（n=28）和卡马西平+丙戊酸钠+氯巴占（n=31）。
联合治疗是我们的三级护理中心非常常见的做法。丙戊酸钠是一种常用的 AED，可很好地控制全身性发作，而卡马西平单独或联合使用也可很好地控制局灶性发作。本研究强调了可控制不同类型发作的常用 AED 组合。
