Year: 2026 | Month: April-June | Volume: 11 | Issue: 2 | Pages: 143-152
DOI: https://doi.org/10.52403/ijshr.20260218
Prescription Pattern of Antiepileptic Drugs in Patients with Refractory Epilepsy: A Cross-Sectional, Observational Study from a Tertiary Care Centre in North India
Punit Kanaujia1, Atul Jain2, Pradeep Kr. Maurya3, Arpita Singh4, Pooja Shukla5, Arvind Kumar Singh6, Garima Verma7
1Senior Resident, Department of Pharmacology, Dr. RMLIMS, Lucknow, India
2Professor, Department of Pharmacology, MMCMSR Sadopur, Ambala, India
3Professor, Department of Neurology, Dr. RMLIMS, Lucknow, India
4Professor & HOD, Department of Pharmacology, Dr. RMLIMS, Lucknow, India
5Additional Professor, Department of Pharmacology, Dr. RMLIMS, Lucknow, India
6Additional Professor, Department of Community Medicine, Dr. RMLIMS, Lucknow, India
7Senior Resident, Department of Pharmacology, Dr. RMLIMS, Lucknow, India
Corresponding Author: Dr. Atul Jain
ABSTRACT
Background: Refractory epilepsy poses significant therapeutic challenges due to poor seizure control and adverse drug effects despite multiple antiepileptic drug (AED) therapies.
Objective: To assess the proportion of patients with refractory epilepsy achieving good seizure freedom on polytherapy, along with their seizure control, clinical profile, radiological profile, EEG patterns and adverse events.
Materials and Methods: This cross-sectional, observational study was conducted over 18 months and involved 130 patients diagnosed with refractory epilepsy who had been receiving polytherapy for more than 6 months. Demographic, clinical, EEG, MRI data and adverse effects of AEDs were analysed. Statistical analyses were conducted using t-tests and Chi-square test, with significance of p ≤ 0.05.
Results: Among 130 patients, 64.62% achieved a good outcome (seizure-free for 6 months). 70.24% males belong to good outcomes in comparison to females (29.76%). Mean age of patients with good outcomes (29.40 ± 11.14 years) and (26.76 ± 10.53 years) in poor outcomes. Mean BMI in the good outcome group is (22.70±2.57), while (21.15 ±3.28) in the poor outcome group (p-value of 0.003, demonstrating a statistically significant association). Vegetarians (40.48%) had better outcomes in contrast to non-vegetarians (p-value =0.026, statistically significant association). Idiopathic epilepsy was the most common etiology followed by granuloma. Levetiracetam, Oxcarbazepine, and Valproic acid are used in similar proportions among patients with both good and poor seizure outcomes. Generalised seizures were more common than focal seizures. Most common adverse effects reported were constipation, anxiety, sedation, dizziness, fall, sedation and weight gain.
Conclusion: Although polytherapy remains essential in refractory epilepsy management, rational prescription is crucial. Increased use of newer AEDs may improve outcomes while minimizing adverse effects.
Keywords: Refractory epilepsy, Antiepileptic drugs, Polytherapy, Prescription patterns