Trend analysis of The uTilizaTion of anTiepilepTic drugs in pregnanT women wiTh epilepsy in moravian-silesian region of The czech republic Trend analysis of the utilization of antiepileptic drugs in pregnant women with epilepsy in Moravian-Silesian region of the Czech Republic

Aim: Little is known about the consumption of antiepileptic drugs in pregnancy in the Czech Republic, particularly for newer agents. In our previous paper, we discussed long-term trends in the utilization of antiepileptic drugs during pregnancy in a group of 235 women between 1991–2006. Currently, we continue to investigate the long-term trends in antiepileptic drug use in pregnant women. Method: A retrospective study analysed data from 208 pregnant women receiving antiepileptic drugs between January 2007 and May 2016. The request forms for routine therapeutic drug monitoring were used as the data source. Monoversus polytherapy, the utilization of individual antiepileptic drugs, and the utilization of combinations were analyzed during two periods (2007–2011, 2012–2016) and the data were compared with our previous study. Results: Monotherapy was used during the first period (2007–2011) in 83% of women and during the second period (2012–2016) in 68% of women, which was significantly lower. The most frequently prescribed antiepileptic drugs were lamotrigine, valproic acid, and carbamazepine during 2007–2011, and lamotrigine, levetiracetam, and carbamazepine during 2012–2016. Carbamazepine + valproic acid was found as the most widely administered combination during 2007–2011 and lamotrigine + levetiracetam during 2012–2016. Conclusions: Our study demonstrates the long-term trends in the utilization of antiepileptic drugs in pregnant women with epilepsy. A significant shift from phenytoin, carbamazepine, and primidone to carbamazepine, lamotrigine, and valproic acid was found between 1991–2006, and from lamotrigine, valproic acid, and carbamazepine to lamotrigine, levetiracetam, and carbamazepine between 2007–2016. Prescription of valproic acid has declined during 2007–2016 with an increase in the use of newer antiepileptic drugs, which is concordant with the current recommendations.