Abstract
In most of the epilepsies and epileptic syndromes, the decision to initiate antiepileptic drug (AED) therapy is often a far simpler one than the decision to stop it. The primary factor that drives a patient to want to discontinue therapy, and a doctor to endorse or recommend this, is a fear of long-term adverse events, a consideration that may be entirely justified as the side effects of vigabatrin and felbamate have proved. On the other hand, seizure recurrence with the attendant implications in employment, driving regulations and social stigmatization is a strong deterrent that discourages withdrawal of therapy. The absence of a clearer understanding of the natural history and prognosis of many individual epilepsy syndromes somewhat hampers the resolution of this dilemma. Hopefully, as our understanding of the epilepsies grows and the prediction of the chances of seizure relapse becomes a more precise science, stopping medication will become a less fraught exercise for both the patient and the doctor.
Keywords: Epilepsy, Seizure freedom, Seizure recurrence, Epilepsy syndromes
Current Pharmaceutical Design
Title: Stopping Drug Therapy in Epilepsy
Volume: 6 Issue: 8
Author(s): S. D. Lhatoo and J.W.A.S. Sander
Affiliation:
Keywords: Epilepsy, Seizure freedom, Seizure recurrence, Epilepsy syndromes
Abstract: In most of the epilepsies and epileptic syndromes, the decision to initiate antiepileptic drug (AED) therapy is often a far simpler one than the decision to stop it. The primary factor that drives a patient to want to discontinue therapy, and a doctor to endorse or recommend this, is a fear of long-term adverse events, a consideration that may be entirely justified as the side effects of vigabatrin and felbamate have proved. On the other hand, seizure recurrence with the attendant implications in employment, driving regulations and social stigmatization is a strong deterrent that discourages withdrawal of therapy. The absence of a clearer understanding of the natural history and prognosis of many individual epilepsy syndromes somewhat hampers the resolution of this dilemma. Hopefully, as our understanding of the epilepsies grows and the prediction of the chances of seizure relapse becomes a more precise science, stopping medication will become a less fraught exercise for both the patient and the doctor.
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Cite this article as:
Lhatoo D. S. and Sander J.W.A.S., Stopping Drug Therapy in Epilepsy, Current Pharmaceutical Design 2000; 6 (8) . https://dx.doi.org/10.2174/1381612003400317
DOI https://dx.doi.org/10.2174/1381612003400317 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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