Pharmaceutisch Weekblad

, Volume 11, Issue 2, pp 50–55 | Cite as

Retrospective analysis of drug treatment in epileptic patients

  • H. T. Rwiza
  • A. Keyser
  • Y. A. Hekster
  • M. Pool
  • H. Verwey
Original Articles


An epidemiological analysis was performed of the adult, out-patient epilepsy clinic population of a university hospital during the period from 1 January 1981 through 30 June 1985. The number of patients that could be traced amounted to 590. An at random sample of 207 were retrospectively analysed. Gender distribution was male:female = 1.46. The mean age was 37.4 years. The diagnoses were classified according to the classification of the International League Against Epilepsy (ILAE). A preponderance of partial seizures was present, reflecting the selection in a university out-patient clinic of more difficult to treat forms of epilepsy. Antiepileptic drugs used in the treatment varied; monotherapy was obtained in 46% of the cases and carbamazepine was the most frequently prescribed drug (49%). Changes in seizure severity and factors associated with epilepsy are described. A discrepancy was found between the suspected drug levels, based upon the physician's judgement, and the plasma level measured in those patients in whom drug levels were monitored; factors interfering with clinical judgement are discussed.


Anticonvulsants Drug monitoring, therapeutic Drug utilization Epidemiology Epilepsy 


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  1. 1.
    Schobben AFAM. Pharmacokinetics and therapeutics in epilepsy [Dissertation]. Nijmegen: Catholic University of Nijmegen, 1979.Google Scholar
  2. 2.
    Guelen PJM, Van der Kleijn E. Rational anti-epileptic therapy. Amsterdam: Elsevier/North Holland Biomedical Press, 1978.Google Scholar
  3. 3.
    Sakshaug S, Andrew M, Hjort PF, Lunde PKM, Øydvin K. Drug utilization in Norway during the 1970's. Oslo: Norwegian Medicinal Depot, 1983.Google Scholar
  4. 4.
    Wuis EW, Hekster YA, Zuidgeest LJB, De Goede WJ, Hommes OR, Keyser A. Drug utilization patterns of antiepileptic drugs in a university hospital. J Soc Admin Pharm 1985;2(3):59–63.Google Scholar
  5. 5.
    Vincze Z, Vincze-Vermes M. Drug utilization of antiepileptics in Hungary. Hosp Form 1984;19:327–32.Google Scholar
  6. 6.
    Rwiza HT. Epilepsy in adults. A clinical and epidemiological study of 207 out-patients [Dissertation]. Dar es Salaam: University of Dar es Salaam, 1987.Google Scholar
  7. 7.
    Termond EFS, Janssen W, Van der Kleijn E, Vree TB. Een laboratorium rapportage service systeem (LRSS) voor plasmaconcentraties van geneesmiddelen op basis van computer time-sharing [A laboratory report service system (LRSS) for the plasma concentrations of drugs based on computer time-sharing]. TGO 1981;6:845–54.Google Scholar
  8. 8.
    International League Against Epilepsy Commission on Classification and Terminology. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia 1981;22:489–501.Google Scholar
  9. 9.
    International League Against Epilepsy Commission on Classification and Terminology. Proposal for classification of epilepsies and epileptic syndromes. Epilepsia 1985;26:268–78.Google Scholar
  10. 10.
    Juul Jensen P. Epilepsy. A clinical and social analysis of 1020 adult patients with epileptic seizures. Acta Neurol Scand 1964;40(Suppl):5.Google Scholar
  11. 11.
    Shorvon S. Temporal aspects of prognosis in epilepsy. J Neurol Neurosurg Psychiatry 1984;47:1157–65.Google Scholar
  12. 12.
    Kurland LT. The incidence and prevalence of convulsive disorders in a small urban community. Epilepsia 1959;1:143–61.Google Scholar
  13. 13.
    Zielinsky JJ. Epidemiology. In: Laidlaw J, Richens A, eds. A textbook of epilepsy. 2nd ed. Edinburgh: Churchill Livingstone, 1982:2–33.Google Scholar
  14. 14.
    Hauser WA. Nonepileptogenic epileptiform electroencephalografic activity. J Ann Neurol 1985;18:627–35.Google Scholar
  15. 15.
    Granieri E, Rosali G, Tota R, et al. A descriptive study of epilepsy in the district of Copparo, Italy, 1964:1978. Epilepsia 1983;24:502–14.Google Scholar
  16. 16.
    Shamansky SL, Glaser GH. Socioeconomic characteristics of childhood seizure disorders in the New Haven area: an epidemiologic study. Epilepsia 1979;20:457–74.Google Scholar
  17. 17.
    Wagner AL. A clinical and epidemiological study of adult patients with epilepsy. Acta Neurol Scand 1983; (Suppl 94):63–72.Google Scholar
  18. 18.
    Theodore WH, Schulman EA, Porter RJ. Intractable seizures: long-term follow-up after prolonged in-patient treatment in an epilepsy unit. Epilepsia 1983;24:336–43.Google Scholar
  19. 19.
    Goodbridge DMG, Shorvon SD. Epileptic seizures in a population of 6000. I. Demography, diagnosis, classification and role of hospital services. Br Med J 1983; 287:641–4.Google Scholar
  20. 20.
    Li Shi-Chuo, Schoenberg BS, Wang Chung-Cheng, Cheng Xue-Ming, Zhou Shu Shun, Bolis CL. Epidemiology in urban areas of the People's Republic of China. Epilepsia 1985;26:391–4.Google Scholar
  21. 21.
    Joshi V, Katiyar BC, Mohan PK, et al. Profile of epilepsy in a developing country: a study of 1,000 patients based on the international classification. Epilepsia 1977;18:549–53.Google Scholar
  22. 22.
    Danesi MA. Prognosis of seizures in medically-treated adolescent and adult Nigerian epileptics. Trop Geogr Med 1983;35:395–9.Google Scholar
  23. 23.
    Schmidt RD, Wilder BJ. Epilepsy. Philadelphia: FA Davis Company, 1968. (Contemporary neurology series).Google Scholar
  24. 24.
    Gibbs FA, Gibbs EL. Atlas of electroencephalography. 2nd ed. Cambridge: Addison Wesley, 1952:2.Google Scholar
  25. 25.
    Currie S, Heathfield KWG, Porter RJ. Intractable seizures: long-term follow-up after prolonged in-patient treatment in an epilepsy unit. Epilepsia 1983;24:336–43.Google Scholar
  26. 26.
    Fernandez RJ, Samuels MA. Epilepsy. In: Samuels MA, ed. Manual of neurologic therapeutics with essential of diagnosis. 3rd ed. Boston: Little Brown & Company, 1986:81–118.Google Scholar
  27. 27.
    Reynolds EH, Shorvon SD. Monotherapy or polytherapy for epilepsy. Epilepsia 1981;22:1–10.Google Scholar
  28. 28.
    Beardsley RS, Freeman JM, Appel FA. Anticonvulsant serum levels are useful only if the physicians appropriately uses them: an assessment of the impact of providing serum level data to physicians. Epilepsia 1983;24:330–5.Google Scholar
  29. 29.
    Shorvon SD, Reynolds EH. Reduction of polypharmacy for epilepsy. Br Med J 1979;2:1023–5.Google Scholar
  30. 30.
    Goodbridge DMG, Shorvon SD. Epileptic seizures in a population of 600. II. Treatment and prognosis. Br Med J 1983;287:645–7.Google Scholar
  31. 31.
    Danesi MA. Classification of the epilepsies: an investigation of 945 patients in a developing country. Epilepsia 1985;26:131–6.Google Scholar

Copyright information

© Royal Dutch Association for Advancement of Pharmacy 1989

Authors and Affiliations

  • H. T. Rwiza
    • 1
  • A. Keyser
    • 1
  • Y. A. Hekster
    • 2
  • M. Pool
    • 1
  • H. Verwey
    • 1
  1. 1.Institute of NeurologySint Radboud HospitalHB Nijmegenthe Netherlands
  2. 2.Department of Clinical PharmacySint Radboud HospitalNijmegen

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