Prescribing patterns of antiepileptic drugs in Italy: a nationwide population‐based study in the years 2000–2005

Abstract

To evaluate prevalence of use and prescribing patterns of antiepileptic drugs (AEDs) in Italian general practice. Primary care data were obtained from the Health Search Database, a longitudinal observational database implemented by the Italian College of General Practitioners (GPs). We selected 465 061 subjects registered by the end of 2005 in the lists of 320 GPs, homogeneously distributed throughout Italy. Prevalence of AED use was assessed in the entire sample and by drug type, age group, year and main geographic area (north, centre and south/islands). Overall, 24 383 subjects (5.2%) received at least one AED prescription in the study period. Prevalence of AED use (with 95% confidence interval) increased progressively from 7.1 (6.9-7.3) in 2000 to 11.8 (11.5-12.1) in 2005 for old AEDs and from 1.1 (1.0-1.2) to 12.2 (11.9-12.5) for new AEDs. Carbamazepine, phenobarbital and valproic acid were the most common AEDs until 2003, when gabapentin became first. There were no differences in prescribing patterns in the three main geographic areas. Newer AEDs were mostly used in patients aged 65 years and older. The more widespread use of newer AEDs was for mood disorders or pain. Older AED currently remain first line drugs for epileptic disorders. An increasing use of AEDs has been recently observed over a 6-year period in Italian general practice, mostly explained by newer compounds used for conditions other than epilepsy.

Newer Antiepileptic Drugs in Status Epilepticus: Prescription Trends and Outcomes in Comparison with Traditional Agents

“…A similar trend of increasing prescription of newer compounds has already been described not only in SE, but more generally in patients with epilepsy and in the general population (6)(7)(8)(9)(10)20). In the present study, this increase was mainly due to levetiracetam and lacosamide.…”

Birth cohort differences in the use of medications in a Brazilian population of older elderly: the Bambuí cohort study of aging (1997 and 2008)

“…Recent increases have been observed in the use of antiepileptics in other elderly populations 21,30 . The prevalence of epilepsy among the elderly is relatively low, varying from 1% to 3% 31,32 .…”

“…Thus, it is unlikely that increases in the incidence and/or prevalence of this condition would explain the increase from 7% to 22% in the use of antiepileptics in the current study. It is more likely that these medications are being used for other therapeutic purposes, such as pain relief, prevention of migraine, management of bipolar disorder, or neurological treatment of patients with a history of stroke 21,30 . In addition, studies in high-income countries 19,20 have shown an increase in the use of psychoactive drugs, both psychoanaleptics and psycholeptics 33 .…”

Prevalence and Incidence of Epilepsy in Italy Based on a Nationwide Database

“…The GPs were selected on a geographical basis to include patients representing the distribution of the Italian (mostly adult) population [7]. The information collected includes anonymous data about patient demographics, medical diagnoses coded according to the ninth edition of International Classification of Disease (ICD-9-CM), drug prescriptions coded according to the Anatomical Chemical classification system, hospital referrals, diagnostic investigations with results, and date of death.…”