Abstract
PURPOSE/AIM: Primary goal of epilepsy management is to completely eradicate the disease without causing much adverse effects. However, physicians are not achieving this despite availability of antiseizure medicines and therapeutic drug monitoring (TDM) services. The objective was to evaluate 3 years' time trend of antiseizure medications (ASMs) use and primarily compare TDM requisitions for older versus newer ASMs. MATERIALS AND METHODS: This is an analytical, observational time-trend analysis (TTA) of TDM services. The author retrospectively assessed TDM records of 122 statistically computed patients receiving a total of 448 ASMs over 3 years period from January 2019 to December 2021 stored in the department. Z-test, Chi-square test for trend, and trendline were plotted to establish trend. RESULTS: Significant portion of the sample comprised older ASMs (252 of 448, 56.25% [95% confidence interval 46%-65%]). Comparison between monotherapy and polytherapy showed a statistically significant difference (P < 0.05) with trend for polytherapy. The minimum number of ASMs used in polytherapy was two, prescribed to 43.24% of people living with epilepsy. Of the two ASMs combined, the most common combination was of phenytoin and levetiracetam, prescribed to 31.25% of patients receiving two ASMs. Maximum number of ASMs prescribed to patients were five and seen in 2/74 of patients receiving polytherapy. Eighteen percent of referrals cited therapeutic failures with four adverse drug reactions (ADRs) documented at the therapeutic level. CONCLUSION: TTA of ASMs showed that in between 2019 and 2021, there was rising trend for use of newer ASMs. Overall, TDM requisitions for older drugs were more in number than newer drugs. The majority were treated with >1 ASMs, and seizure control was satisfactory with few ADRs documented.