Objectives To evaluate the utilization pattern of anti-epileptic drugs (AEDs) in Indian paediatric patients and compare it with the global usage data. Methods Paediatric patients (≤18 years) with a confirmed diagnosis of epilepsy and prescribed with at least one AED were included in the study from a child neurology clinic in Pune, Maharashtra, India. The data pertaining to the type of epilepsy, and drug therapy was obtained retrospectively. The prescribing pattern of AEDs was identified and compared with the drug utilization pattern of the Asian and European countries from a systemic literature review. Key findings Out of the 343 paediatric patients enrolled in the study, 55.6% were males. Thirty-four per cent of the patients were under the age group of 2-6 years. More than half (60.5%) of the patients were diagnosed with generalized seizures, with tonic-clonic seizures (48%) being the most common among them. Out of the 37.9% of patients diagnosed with partial epilepsy, simple partial seizure was the most common type. The most commonly prescribed drug was sodium valproate for both generalized and partial seizures. Levetiracetam was found to be the preferred newer AED for management of generalized epilepsy. Similar prescribing pattern was seen in Asian countries where sodium valproate was the most preferred AED followed by levetiracetam and oxcarbazepine. Sodium valproate was also highly prescribed in European countries while levetiracetam and oxcarbazepine were underused. Two hundred and seven patients (60%) were managed on monotherapy.Conclusions Older generation AEDs are still used in majority of patients as mono and dual therapy. Among the newer generation AEDs, there is an increase in the utilization of levetiracetam. Prescription of AEDs in our study goes in line with Asian countries but differs with the European counterparts due to various reasons.

Background: Generic substitution is preferred to reduce healthcare costs and improve patient adherence. The review of literature showed that physicians all around the world were not comfortable in prescribing generic medications due to the lack of evidence on their safety and efficacy. Methods: A prospective study was conducted over a period of one year in Pune. The patients were categorized on their age and were assessed for the clinical effectiveness data (no. of breakthrough seizures and seizure free days) and safety data (no. of ADR episodes). The mean number of patients controlled and the frequency of adverse events at the 3 rd and 6 th month were calculated. Results: Authors assessed 150 newly diagnosed pediatric epileptic patients who received anti-epileptic drug monotherapy for at least 6 months, out of which 46 (30.66%) received Oxcarbazepine and 104 (69.33%) received Sodium Valproate. At the end of 3 months of therapy 140 (93.33%) patients were seizure free and 145 (96.66%) patients were seizure free at the end of 6 months. Adverse effects were observed in 14 (30.43) patients on oxcarbazepine and 26 (25%) patients on sodium valproate. The most common adverse effect was weight gain in 34 (22.66%) patients with both the AEDs. Conclusions: Seizure control was achieved in majority of the patients. In addition to the seizure control, the frequency of adverse effects was few and tolerable by the patients when prescribed with low cost branded generics.