Stopping antiepileptic drugs – other factors to consider

I read the informative article ‘Discontinuation of antiepileptic drugs in adults with epilepsy’ by Hanka Laue-Gizzi¹ and would like to highlight a few points regarding the factors which can affect the outcomes for patients.

The author described factors associated with seizure recurrence. A few more factors worth mentioning include the type of seizure, neurological examination, and any family history of epilepsy. Patients who had a single seizure type have more chance of remaining seizure-free after drug withdrawal. Generalised seizures have a better prognosis compared to focal seizures. Patients with a normal neurological examination have more chances of remaining seizure-free after drug withdrawal as do patients with no family history of epilepsy.²

The article also described important considerations for counselling. Apart from driving, patients should refrain from potentially dangerous activities such as swimming during the first three months after discontinuing therapy.²

Ajay Kumar Shukla
Assistant professor, Department of Pharmacology, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India

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