Abstract

A RETROSPECTIVE STUDY ON THE PRESCRIBING PATTERN AND EFFICACY COMPARISON OF ANTICONVULSANTS IN PAEDIATRIC EPILEPSY POPULATION IN A TERTIARY CARE HOSPITAL

Anna Sneha Samuel*, Ashna Susan John, Jeenu Joseph, Preethu P. John and Dr. Santhosh M. Mathews

ABSTRACT

Introduction: Epilepsy is a chronic neurological disorder affecting people across the globe. More than 10 million children worldwide have some forms of epilepsy and it has been suggested that the lack of efficacy is the primary reason for treatment failures rather than adverse effects. Wherever treatment is deemed necessary, medication with anti convulsants is generally the first line therapy. The aim of the study was to evaluate the prescribing pattern and compare the efficacy of anti convulsants in paediatric epilepsy population. Methods: A retrospective study was conducted in the department of paediatrics for a period of 6 months and 1 year data was collected. Patients who satisfied both inclusion and exclusion criteria were taken for the study. WHO prescribing indicators were used to assess the prescribing pattern of anti convulsants and recurrence rate of seizures to compare the efficacy of prescribed AEDs. Results: Total number of the study population was 115 and the mean age of the study population was 6.25±4.07. Majority of patients belongs to the age group 1-6 years. Epileptic seizures were found to be more prominent in males. Majority of the children were on monotherapy (67.8%) followed by dual therapy (26.08%). Levetiracetam was the highly prescribed AED monotherapy and Sodium valproate + clobazam as AED dual therapy. Out of 115 patients, older AEDs were most commonly preferred than the newer drugs and has resulted in better control of seizure episodes (p=0.010). Percentage of drugs prescribed by generic name and from the Essential drug list were found to be less according to WHO prescribing indicators. Sodium valproate monotherapy was found to have the lowest recurrence rate for seizures(16%). Overall 13% of study population had adverse effects and highest incidence observed with Sodium valproate. Conclusion: It is hoped that the objectives are met. Among the study population, 67.8% responded to monotherapy while others required combination therapy. Our study suggests that prescribing by generic name needs to be promoted. The study concluded that Sodium valproate was the better efficacious drug. Eventhough Sodium valproate showed highest incidence of adverse effects, it had better tolerability since none of the ADRs obtained were clinically significant. Because of the lack of data on the efficacy and safety of the new AEDs, their applications depend on the clinician’s own experiences.

Keywords: Epilepsy, Paediatrics, Prescribing pattern, WHO prescribing indicators, Anti epileptic drugs (AEDs), Efficacy.