Guidelines for Withdrawal of Anti-Epileptic Drugs in Seizure-Free Patients

Abstract

The ultimate goal of epilepsy treatment is to become seizure free and live a healthy life without the need to take antiepileptic drugs may cause several tricky and sometimes serious side-effects. There is no class I evidence that is based on randomized double-blind trials for withdrawal of antiepileptics in adults who become seizure-free while taking such drugs. Whether or not antiepileptic drugs should be withdrawn after a patient has been seizure-free is a challenging concern for several years. Certain studies advise that the total risk of seizure recurrence is approximately 30%, if treatment is withdrawn. The clinical factors associated with a greater chance of successful withdrawal include childhood onset epilepsy, monotherapy, being seizure-free for more than two years, a normal electroencephalogram prior to drug withdrawal, normal neuroimaging and normal intellect. Withdrawal should be gradual and take place over roughly 6 months. Several useful review articles, guidelines, and meta-analyses have been published on the subject of antiepileptic drug withdrawal. Tapering the dose plays essential role in while withdrawal of an antiepileptic drug. The discontinuance of antiepileptic drugs may be patient or parent/guardian meets a profile by considered the physician.

Keywords: Antiepileptic drugs, epilepsy, seizure-free, withdrawal