Utilization of Antiepileptic Medicines in Swedish Children and Adolescents With Different Diagnoses

Basic Clin Pharmacol Toxicol. 2018 Jul;123(1):94-100. doi: 10.1111/bcpt.12981. Epub 2018 Mar 30.

Abstract

This study aimed to investigate the utilization of antiepileptic drugs (AEDs) in children and adolescents with epilepsy and other diagnoses in a nationwide population between 2007 and 2014. Data on dispensed prescriptions of AEDs were collected from the Swedish Prescribed Drug Register and linked to diagnosis data from the National Patient Register covering all in- and outpatient consultations from Swedish hospitals. Children aged 0-17 years who had received at least one prescription for AEDs were selected. We calculated proportions of patients stratified by indication, sex and type of AED. A total of 18,131 patients (mean age 9.5 years, 50% boys) were initiated on AED treatment between January 2007 and December 2014. Epilepsy was the most frequent diagnosis (46%) recorded within the year prior to the first AED dispensing. Psychiatric and pain diagnoses were more common in girls (sex distribution 70/30 and 59/41, respectively). In epilepsy, the most frequently initiated AED was valproic acid in boys and lamotrigine in girls. Lamotrigine was the most frequently initiated drug in psychiatry, in both boys and girls. This nationwide study provides new knowledge on AED use in children and adolescents. The use of AEDs during the study period was mainly restricted to epilepsy, and the individual AEDs used seems to be in accordance with approved indications. However, the use of AED on non-epilepsy diagnoses, especially pain disorders, raises concerns.

MeSH terms

  • Adolescent
  • Anticonvulsants / therapeutic use*
  • Child
  • Child, Preschool
  • Drug Prescriptions / statistics & numerical data
  • Drug Utilization / statistics & numerical data*
  • Epilepsy / drug therapy*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Lamotrigine
  • Male
  • Mental Disorders / drug therapy
  • Migraine Disorders / drug therapy
  • Off-Label Use / statistics & numerical data
  • Pain / drug therapy
  • Practice Patterns, Physicians'
  • Prescription Drugs / therapeutic use*
  • Registries / statistics & numerical data*
  • Sex Factors
  • Sweden
  • Triazines / therapeutic use
  • Valproic Acid / therapeutic use

Substances

  • Anticonvulsants
  • Prescription Drugs
  • Triazines
  • Valproic Acid
  • Lamotrigine