August 12, 2020

Switching Antiepileptic Drugs to Once-daily Dosing Regimens in Epilepsy Patients

Abstract, published in Acta Neurologica Scandinavica

Background & Objectives: Antiepileptic drug (AED) non-adherence is an important factor contributing to poor seizure control in patients with epilepsy. The aim of this study is to investigate seizure improvement after switching AEDs to once-daily dosing regimens in patients with drug-resistant epilepsy related to AED non-adherence. Successful switching was defined by at least 70% reduction in seizure frequency without troublesome adverse events.

Results: Among 401 patients with drug-resistant epilepsy, 88 patients with AED non-adherence were switched to once-daily dosing regimens. Forty-six patients (52.3%) experienced successful seizure control following the switch. A higher chance of successful switch was found in patients without an MRI (magnetic resonance image) abnormality (16/46 vs. 24/42) and in patients who were switched to extended-release formulations or different AEDs with longer half-lives (33/46 vs. 19/42).

Conclusions: Our study shows that switching AEDs to once-daily dosing regimens was an effective therapeutic option in patients with poor seizure control related to AED non-adherence. Treatment with extended-release formulations or drugs with longer half-lives should be considered in these patients.