COMMENTARY

'Of Course I Take My Seizure Meds, Doctor'

Andrew N. Wilner, MD

Disclosures

February 13, 2015

Antiepileptic Drug Nonadherence

Failure to take prescribed doses of antiepileptic drugs is a common cause of seizures that require hospitalization, according to a recent Norwegian study.[1] Surprisingly, nearly half of the nonadherent patients claimed that they took their medication regularly.

The investigators measured antiepileptic drug levels of 282 consecutive patients with epilepsy admitted to the hospital for seizures and compared them with the patients' baseline levels. Serum levels < 50% of baseline on admission were considered evidence of "definite" nonadherence, whereas levels between 50% and 75% were considered "probable" nonadherence.

Study Findings

Definite nonadherence occurred in 24% and probable nonadherence in 15%, for a total of 39% of epilepsy patients admitted to the hospital for seizures. Among the nonadherent patients, 44% claimed that they took their antiepileptic drugs regularly, which was inconsistent with the laboratory data. Younger patients were more likely to be nonadherent; nearly 37% of patients younger than 30 years were definitely nonadherent vs 27% of patients aged 30-60 and only 10% of patients older than 60 years. Moreover, patients with generalized seizures were more likely to be nonadherent than those with focal seizures. There was no significant difference in adherence rates with respect to sex, monotherapy vs polytherapy, or patients living alone vs those living with others.

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