Comparison of Anti-Epileptic Drugs in Terms of Treatment Outcomes, Adverse Effects and Quality of Life

Abstract

Introduction: Epilepsy is a disorder of the nervous system requiring prompt medical care and life-long treatment. Unfortunately, data regarding efficacy, Adverse Drug Reactions (ADRs) and Quality Of Life (QOL) in patients using different AntiEpileptic Drugs (AEDs) is sparse. Aim: To evaluate five AEDs in comparison for efficacy in reducing seizures, improvement in QOL and ADRs due to the prescribed drug. Materials and Methods: In this cohort study, 81 epilepsy patients (age >10 years) receiving the following drugs: Levetiracetam, Lacosamide, Oxcarbazepine, Valproate and Phenytoin for atleast six months were enrolled. Quality of Life in Epilepsy Inventory–31 (QOLIE-31) questionnaire was used for measuring the QOL. Efficacy of AEDs was measured on the basis of seizure control, QOL and adverse effects. All the patients were followed-up weekly for six months for treatment response and adverse effects. Overall, QOLIE scores were calculated. T-tests, analysis of variance and regression analysis were used wherever appropriate. The p-value <0.05 was considered statistically significant. Results: Seizure control was reported in 79% of the patients. A total of 43.2% patients were reported to have experienced an ADR during the course of the study. Adverse events predominantly affected gastroenterologic, psychiatric and general body systems. Patients on Levetiracetam had the best QOL and phenytoin the least. Conclusion: Better seizure control, high medication adherence and improved QoL was seen in patients with Levetiracetam; followed by Lacosamide, Oxcarbazepine, Valproate and least in Phenytoin.

Keywords

• causality assessment
• focal epilepsy
• generalised tonic clonic epilepsy
• medication adherence
• seizures