Prescription Pattern of Antiepileptic Drugs in Southern Pakistan: A Retrospective Cohort Study in Tertiary Care Centres

Epilepsy is the most occurring neurological disorder after stroke.Prevalence of epilepsy is about 9.99 per 1000 population in Pakistan.In recent years, about 14 new antiepileptic drugs (AEDs) have been marketed.Irrational drugs prescribing might decrease patient adherence with therapy and cause therapeutic failure.The aim of the current study was to evaluate the incidence of different types of epilepsy with syndromes and use of AEDs in patients with epilepsy in detail in a population, characterized by gender and age differences, with focus on exposure of AEDs, in Karachi-Pakistan.It reveals the results of a retrospective cohort study conducted during the period of June 2015 to May 2017 at General Neurology wards of different tertiary care hospitals of Karachi, Pakistan.Prescriptions (n = 90,356) were randomly collected along with the diagnostic data of patients with epilepsy.Variables included exposure of AEDs, polytherapy, age and gender differences, AEDs dosages and Non-AEDs in the same prescription.Total of 21 AEDs were utilized during the two-year study.Variations in the prescription pattern were noticed with respect to age and gender differences.Seventy-four percent of patients with epilepsy have utilized more than one AED.Levetiracetam (38%) was the most prescribed drug among all AEDs used in hospitals of Karachi, Pakistan.Valproic acid was still the most commonly utilized AED in children after inclusion its name in black box warning drug list.This study revealed the discrepancies related to dosages of commonly prescribed AEDs.The study indicates higher prevalence of irrational use of AEDs and the discrepancies in the dosing of mostly drugs.The achieved outcomes may provide sufficient basis for pharmacovigilance studies to health care authorities. RezumatEpilepsia este cea mai frecventă tulburare neurologică ce apare după accident vascular cerebral.Prevalența epilepsiei este d e aproximativ 9,99 la 1000 locuitori în Pakistan.În ultimii ani, au fost comercializate aproximativ 14 noi medicamente antiepileptice (AEDs).Medicamentele irațional prescrise scad complianța pacientului la terapie și induce insuficiență terapeutică.Scopul studiului a fost de a evalua incidența diferitelor tipuri de epilepsie și utilizarea AEDs la pacienții cu epilepsie, în Karachi-Pakistan.Este prezentat un studiu retrospectiv de cohortă, realizat în perioada iunie 2015mai 2017 în secțiile de neurologie ale unor spitale din Karachi, Pakistan.Prescripțiile (n = 90.356)au fost colectate aleatoriu împreună cu datele de diagnostic ale pacienților.Variabilele au inclus expunerea la AEDs, politerapia, vârsta, sexul, dozele de AEDs și non-AEDs pe aceeași prescripție.21 de AEDs au fost utilizate pe parcursul celor doi ani de studiu.74% dintre pacienții cu epilepsie au utilizat mai mult de un AED.Levetiracetamul (38%) a fost cel mai prescris medicament.Acidul valproic a fost cel mai frecvent utilizat AED la copii.Acest studiu a relevat discrepanțele legate de dozele de AEDs frecvent prescrise.