TITLE:
Mono-Therapy versus Poly-Therapy: Ten Years Indian Experience on Various Seizure Disorders
AUTHORS:
Deepak Goel, Manish Mittal
KEYWORDS:
Antiepileptic Drugs, Refractory Epilepsy, Rationale Poly-Therapy
JOURNAL NAME:
World Journal of Neuroscience,
Vol.5 No.5,
November
13,
2015
ABSTRACT: Objectives: To find out
prescription patterns and seizure freedom with different mono-, duo- and
poly-therapies used in various seizure disorders in Indian setting. Material
and Methods: Subjects with seizures, not responding to first antiepileptic
drug, were evaluated prospectively for a period of 6 months. Patients on
various dual antiepileptic drugs (AEDs) prescriptions were prospectively
analyzed for 1) the pattern and frequency of different duo-therapies; 2)
etiological profile of patients in duo-therapy prescription; and 3) frequency
of seizure freedom on various duo-therapy groups. Results: Among 2542 patients,
293 (11.5%) lost in follow-up and thus, 2249 (88.5%) were followed. 1324
(58.9%) had seizure freedom on mono-therapy, 532 (23.7%) required duo-therapy
and only 45 (2%) were better controlled on poly-therapy. Among the subjects,
who were on mono-therapy,
Carbamazepine/Oxcarbazepine was the most commonly prescribed in 1285 (50.55%) patients as first drug followed by
Valproate compound and Phenytoin. The most common duo-therapy used was
combination of Valproate with Lamotregine, followed by Phenytoin and
Phenobarbitone. Other mono-therapy and combinations are given in this paper.
Conclusions: Duo-therapy was required and found to be effective in 23.7% of
Indian patients with epilepsy. Selection of appropriate two drug combination is
based on individual approach and overall clinical profile of patient.