Switching antiepileptic drugs to once-daily dosing regimens in epilepsy patients.

ABSTRACT

BACKGROUND: Antiepileptic drug (AED) non-adherence is an important factor contributing to poor seizure control in patients with epilepsy. AIM: The aim of this study is to investigate seizure improvement after switching AEDs to once-daily dosing regimens in patients with drug-resistant epilepsy related to AED non-adherence. METHODS: We performed a 10-year retrospective analysis of drug-resistant epilepsy patients whom AED non-adherence attributed to drug resistance and switched AEDs to once-daily dosing regimens. Successful switching was defined by at least 70% reduction in seizure frequency without troublesome adverse events. RESULTS: Among 401 patients with drug-resistant epilepsy, 88 patients with AED non-adherence were switched to once-daily dosing regimens. Forty-six patients (52.3%) experienced successful seizure control following the switch. A higher chance of successful switch was found in patients without MRI abnormality (16/46 vs. 24/42; P = .04) and in patients who were switched to extended-release formulations or different AEDs with longer half-lives (33/46 vs. 19/42; P = .02). CONCLUSIONS: Our study shows that switching AEDs to once-daily dosing regimens was an effective therapeutic option in patients with poor seizure control related to AED non-adherence. Treatment with extended-release formulations or drugs with longer half-lives should be considered in these patients.