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Observational Study
. 2023 Dec:113:23-27.
doi: 10.1016/j.seizure.2023.10.016. Epub 2023 Nov 2.

Prevalence and nature of patient-reported antiseizure medication side effects in a Swedish regional multi-center study

Johan Zelano  1 , Olha Nika  2 , Fredrik Asztely  3 , David Larsson  2 , Klara Andersson  2 , Kerstin Andrén  3
Affiliations
Free article
Observational Study

Prevalence and nature of patient-reported antiseizure medication side effects in a Swedish regional multi-center study

Johan Zelano et al. Seizure. 2023 Dec.
Free article

Abstract

Purpose: Side effects is one of the major clinical problems in epilepsy care. We assessed the prevalence of ASM side effects in participants in a large regional multicenter observational study in western Sweden and aimed to identify risk factors and inventory the nature of side effects with different ASM regimes.

Methods: Cross-sectional analysis of survey answers and clinical characteristics of 406 adult participants recruited to a regional observational study between December 2020 and March 2023. Half of the participants had been seizure free for one year. Second-generation or newer ASMs were the most common.

Results: A total of 164 (40 %, 95 %CI: 36-45) patients reported side effects. Patients reporting side effects were younger (median 41 vs 47 years, p = 0.015), had more frequently experienced a seizure in the last year (p = 0.02), and were more often on ASM polytherapy (p < 0.01). ASM polytherapy and age were significant risk factors in regression models, but the explanatory value was low. The most common side effect was tiredness followed by cognitive symptoms.

Conclusions: Our findings show that side effects are still common in epilepsy care and suggests that unnecessary polypharmacy should be avoided. Apart from number or ASMs, predicting who will experience side effects is difficult and more research on individual vulnerability is needed.

Keywords: Epilepsy; Side effects; Treatment.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests Johan Zelano reports a relationship with UCB Pharma AB that includes: speaking and lecture fees. Johan Zelano reports a relationship with Eisai AB Sweden that includes: speaking and lecture fees. Fredrik Asztely reports a relationship with Angelini Pharma AB that includes: speaking and lecture fees. Johan Zelano reports writers honoraria/royalties/associate editor fee from Liber AB, Neurologi i Sverige, Studentlitteratur AB, and Wiley, respectively.

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