Drug Utilization Evaluation of Antiepileptics in Three Selected Multidisciplinary Teaching Hospitals of Pakistan

Objective: To identify the utilization pattern of antiepileptic drugs (AEDs) in a representative sample of the Pakistani population. To highlight the main risk factors associated with different forms of epilepsy. Methods: A retrospective drug utilization review study was conducted at three teaching institutions of Karachi. During the nine months study period, epileptic and non-epileptic patients who were prescribed with AEDs were enrolled consecutively. Data were collected through the integration of computerized records and standard performa to retrieve information on age, gender, diagnosis, type of seizure and AEDs data. The results were analyzed by univariate statistics. Results: Total 622 patients i.e., 426 epileptic and 196 non-epileptic patients who were prescribed with AED were analyzed in the study. The age ranged from 0.1 to 82 years (median, 36), there were 56% male and 44% female patients. Simple partial seizure (28%) was most common type of seizures. Monotherapy accounted for 77% of total epileptic patient. Idiopathic/cryptogenic was most common etiology of epileptic seizure (41%). CNS infections (57%) was leading cause of symptomatic epilepsy. Most prevalent utilization of AEDs for non-epileptic condition was neuropathic pain (55%). In epileptic patients, Valproate (17%) and diazepam (14%) whereas in non-epileptic patients, gabapentin (26%) and pregabalin (20%) was most commonly prescribed drugs. Conclusion: Despite the availability of newer antiepileptics in Pakistan, the domain of classic agents were still dominated in pharmacotherapy of epileptic seizure. The utilization patterns reported here are in agreement with general guidelines except for extensive prescribing of diazepam and some drug that use off label.