TITLE:
Discontinuation of AEDs: When and how?
AUTHORS:
Taoufik Alsaadi, Mustafa Shakra, Lamya Turkawi
KEYWORDS:
Epilepsy; Discontinuation of Antiepileptic Drugs (AEDs); Outcome of Recurrences
JOURNAL NAME:
Health,
Vol.5 No.6A,
June
17,
2013
ABSTRACT:
Once a patient has initiated an antiepileptic drug (AED) and achieved a
sustained period of seizure freedom, the decision to discontinue AED should
be balanced against continuation of AED therapy indefinitely. Studies show that
the rate of seizure recurrence after AED withdrawal is about two to three times
the rate in patients who continue AEDs. However, there are many benefits to
AED withdrawal that should be evaluated on an individualized basis. AED discontinuation
may be considered in patients whose seizures have been completely controlled
for a prolonged period. There are several factors that would increase risk of
recurrences which will be reviewed and discussed. As a consequence, the decision to withdraw or withhold treatment must be still individualized. In any
patient, the decision to discontinue treatment should also take into effect
the social aspects like driving license, job and leisure activities as well as
emotional and personal factors and patients with adverse effects or drug
interactions. Patients will ultimately have to decide themselves whether they
wish to discontinue drug treatment.