Abstracts

Rationale: Despite significant advances in the medical management of epilepsy, treatment outcomes for up to a third of patients with epilepsy are suboptimal. In recent trials, the efficacy of AEDs has been demonstrated by a = 50% reduction in seizures. However, the reported incidence of patients experiencing an adverse drug reaction (ADR) due to an AED is as high as 88%, undermining the true effectiveness of AEDs. DRE is associated with serious psychosocial consequences, reduced quality of life, cognitive problems, and increased risk of sudden death. To date, there is limited information on patient perception or preference for specific AEDs, both in terms of seizure control and side-effect profile. Methods: A retrospective chart review was conducted for all veterans with a diagnosis of DRE seen in Seizure Clinic at the VAGLAHS from 7/1/2008 to 6/30/2017. Veterans were asked to rank their AEDs based on 1) seizure control and 2) seizure control and ADRs. Veterans who were unable to provide information on ranking of their AEDs were excluded from the study (59%). Results: Of the 463 patient charts reviewed, 192 (41.5%) met inclusion criteria. Average duration of epilepsy was 22.0 years; average number of failed AEDs was 4.0. Patients were on an average of 1.9 AEDs during the survey. There was a total of 437 (49.8%) AED-related ADRs reported for 878 AEDs prescribed to 192 veterans. When looking at the first ranked AED for seizure control only, 49.0% reported an ADR, 42.7% reported no ADR, 8.3% were indeterminate. Conclusions: In our sample, nearly half of the veterans with DRE experienced an ADR with their first ranked AED.  We are in the process of further analyzing veterans’ prioritization of AEDs and their associated ADRs in relationship to their perceived effectiveness. Funding: There was no funding support for this study.