Abstract
INTRODUCTION: Epilepsy is increasingly prevalent among older adults, with stroke, neurodegenerative diseases, and brain tumors being the most common etiologies. Treatment in this population is complicated by age-related physiological changes and the risk of polypharmacy, requiring careful selection of antiseizure medications (ASMs). METHODS: A retrospective chart review was conducted for patients aged 60 years and above who were newly diagnosed with epilepsy and attended the neurology clinics at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between January 2015 and December 2020. Demographic and clinical data, including ASM prescriptions and tolerability, were analyzed using SPSS version 20 (SPSS Statistics developed by IBM for data management, Armonk, New York, United States of America). RESULTS: A total of 82 patients were included (mean age: 69 years; 58.5% male). Levetiracetam (LEV) was the most commonly prescribed ASM (69.5%), followed by phenytoin (37.8%). Valproic acid, carbamazepine, lamotrigine (LTG), and topiramate were used to a lesser extent. Prescription patterns did not significantly differ by age group or gender. LEV was favored due to its favorable safety profile and minimal drug interactions. CONCLUSION: LEV is the most preferred ASM for elderly patients with epilepsy in Jeddah, likely due to its efficacy, tolerability, and low interaction risk. Individualized treatment strategies remain essential, given the complex comorbidities and pharmacological considerations in this age group.