Antiepileptic drugs in epilepsy and other disorders—A population-based study of prescriptions

Johannessen Landmark, Cecilie; Larsson, Pål G.; Rytter, Elisif; Johannessen, Svein I.

doi:10.1016/j.eplepsyres.2009.07.005

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Volume 87, Issue 1 , Pages 31-39, November 2009

Antiepileptic drugs in epilepsy and other disorders—A population-based study of prescriptions

Cecilie Johannessen Landmark
- Department of Pharmacy, Faculty of Health Sciences, Oslo University College, Pilestredet 50, N-0167 Oslo, Norway
- Corresponding author. Tel.: +47 22 45 23 60; fax: +47 22 45 23 35.
Pål G. Larsson
- The National Center for Epilepsy, Sandvika, Norway
- Division of Clinical Neuroscience, Rikshospitalet, Oslo University Hospital, Oslo, Norway
Elisif Rytter
- The National Center for Epilepsy, Sandvika, Norway
- Division of Clinical Neuroscience, Rikshospitalet, Oslo University Hospital, Oslo, Norway
Svein I. Johannessen
- The National Center for Epilepsy, Sandvika, Norway
- Division of Clinical Neuroscience, Rikshospitalet, Oslo University Hospital, Oslo, Norway
- Department of Clinical Biochemistry, Rikshospitalet, Oslo University Hospital, Oslo, Norway

Received 23 March 2009; received in revised form 31 May 2009; accepted 15 July 2009.

Summary

Purpose

The aim of the study was to quantify the use of antiepileptic drugs (AEDs) in epilepsy and other indications in a nation-wide population using a prescription database.

Materials and methods

Prescription data of AEDs were collected from the Norwegian Prescription Database for the period 2004–2007, including 5.1 million prescriptions from 144,653 patients, all having at least one prescribed and dispensed AED. Diagnosis-related reimbursement codes were used as indicators for clinical use.

Results

Of the AEDs used, 71% was in epilepsy, 15% in psychiatry, 13% in neuropathic pain, and <1% in migraine, trigeminus neuralgia and cancer adjuvance. The use in epilepsy increased steadily from 7.0 to 7.5 DDDs/1000 inhabitants/day (7%) from 2004 to 2007. The use of AEDs in other indications increased considerably more from 2004 to 2007: Neuropathic pain to 1.40 DDDs/1000 inhabitants/day (360%), psychiatry to 1.59 (200%), and migraine to 0.005 (642%). The prevalence of AED users increased and in 2007 it was 0.97% in epilepsy, 0.8% in neuropathic pain, 0.33% in psychiatry and 0.001% in migraine. In 2007, 49% of the AEDs used in epilepsy were a new drug, carbamazepine, lamotrigine and valproate being most frequently used. New AEDs were used in 96% in migraine prophylaxis, 94% in neuropathic pain, and 64% in psychiatry.