Rapid versus slow withdrawal of antiepileptic drugs

The Cochrane Database of Systematic Reviews
L N Ranganathan, S Ramaratnam

Abstract

The ideal objective of treating a person with epilepsy is to induce remission by usage of antiepileptic drugs (AEDs) and withdraw the AEDs without causing seizure recurrence. Prolonged usage of AEDs may have long-term side effects. Hence when a person with epilepsy is in remission (free of seizures for some time) it is logical to attempt to discontinue the medication. The timing of withdrawal and the mode of withdrawal arise while contemplating withdrawal of AEDs. This review proposes to examine the evidence for the rate of withdrawal of AEDs (whether rapid or slow tapering) and its effect on recurrence of seizure. This review also examines the effect of variables such as age of seizure onset, seizure types, presence of neurological deficits, mental subnormality, aetiology of epilepsy, type of AED, EEG findings or duration of seizure freedom on the risk of recurrence of seizures with the two tapering regimens. (1) To quantify risk of seizure recurrence after rapid (taper period of three months or less) or slow (taper period or more than three months) discontinuation of antiepileptic drugs in adults with epilepsy who are in remission. (2) To quantify the risk of seizure recurrence after rapid (taper period of three months or les...Continue Reading

References

Apr 14, 1988·The New England Journal of Medicine·N CallaghanT Goggin
Dec 1, 1987·Journal of Neurology, Neurosurgery, and Psychiatry·P A BoumaJ Van Rossum
Nov 1, 1987·Epilepsy Research·J S Duncan, S D Shorvon
May 7, 1981·The New England Journal of Medicine·R EmersonJ M Freeman
Oct 31, 2002·Statistics in Medicine·Paula R WilliamsonAnthony G Marson
Sep 6, 2003·BMJ : British Medical Journal·Julian P T HigginsDouglas G Altman

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Citations

Jul 4, 2008·Epilepsy Currents·Kimford J Meador
Mar 24, 2017·Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række·Morten I LossiusKarl O Nakken
Dec 19, 2019·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·T M OstroumovaA I Kochetkov
Jan 29, 2020·The Cochrane Database of Systematic Reviews·Fernando Ayuga LoroFrancesco Brigo
Dec 17, 2010·Journal of Neural Transmission·Ettore Beghi
May 28, 2021·Epilepsy & Behavior Reports·Tasneem F Hasan, William O Tatum
Nov 9, 2011·Seminars in Pediatric Neurology·Sarah A Kelley, Adam L Hartman
Jan 11, 2022·The Cochrane Database of Systematic Reviews·Fernando Ayuga LoroFrancesco Brigo

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