Journal of Neural Transmission

, Volume 118, Issue 2, pp 183–186 | Cite as

AED discontinuation may be dangerous for seizure-free patients

Basic Neurosciences, Genetics and Immunology - Review Article

Abstract

Despite its benefits, stopping antiepileptic drugs (AEDs) in seizure-free patients is associated with several risks. AED discontinuation doubles the risk of seizure recurrence for up to 2 years compared with continued treatment. On average, one in three patients has a seizure recurrence, though the range can go up to 66% (34%, range 12–66%, 95% CI: 27–43). Furthermore, the outcome of treating a seizure recurrence in patients who have been seizure-free for years is surprisingly poor in some patients. Although the long-term prognosis is not worsened by drug discontinuation, one in five patients does not re-enter remission and for some patients, it may take several years to become seizure-free again. The risk of seizure recurrence is particularly high for those with juvenile myoclonic epilepsy and symptomatic focal epilepsy, the most frequent epilepsies in adults. Seizure-recurrence may have devastating, medical, psychological and social consequences for the individual, for example injury, loss of self-esteem, unemployment and losing a driver’s license. Discontinuation should be avoided in patients with a high risk of seizure recurrence. Given these risks, patients will ultimately have to decide themselves whether they wish to discontinue drug treatment after full informed consent.

Keywords

Drug discontinuation Risk factors Outcome Epilepsy 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Epilepsy Research GroupBerlinGermany

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