Abstract

Background: Antiepileptic drugs (AEDs) are also commonly used therapy for other conditions like prophylaxis for a manic- depressive disorder, to relieve neuralgic pain and for many more conditions apart from epilepsy. Data suggest that 45% of AEDs prescriptions were for conditions other than epilepsy. All of these uses are off-label except for some AEDs approved for limited indications. Aims and
Objective: To study the AEDs utilization pattern in a tertiary care teaching rural hospital in India.
Materials and Methods: Patients who prescribed AEDs by treating physician from the various outpatient departments of a tertiary care hospital were enrolled in the study irrespective of their diagnosis. Their demographic data, clinical profile and drug use related details were obtained from the case files and history and analyzed.
Results: Out of total 160 patients enrolled, the majority were male 103 (64.4%), in the age group of 18-65 years (123, 76.9%), and from neuromedicine 149 (93.1%) department. 81 (50.63%), 45 (28.12%), and 10 (6.25%) were diagnosed as epilepsy, pain, and psychomotor disorders, respectively, and remaining patients having a dual indication for AEDs prescription. Partial epilepsy (45, 47.87%) was the most common type and cryptogenic (44, 46.80%) was most common aetiological factor among epileptic patients. Average number of AEDs prescribed per patient was 1.331. 113 (70.6%) patients were managed by monotherapy. Most frequently prescribed AEDs were pregabalin (20.19%) followed by phenytoin (16.90%). Conventional AEDs (78.95%) were prescribed more frequently than newer AEDs (21.05%) for epilepsy; while newer AEDs (68.10%) were frequently prescribed in patients suffering from non-epileptic condition. 52% of drugs were prescribed by generic name. No fixed dose combinations of AEDs were prescribed throughout this study period.
Conclusions: The use of AEDs not limited to epilepsy only. AEDs were prescribed more frequently in neuropathic pain and psychiatric disorders other than epilepsy. AEDs are usually prescribed as monotherapy and by generic name and not as fixed dose combination. Awareness about off-label use of ADEs is essential for its appropriate use.