ArticleEpilepsy & behavior : E&B2020
Polypharmacy in patients with epilepsy: A nationally representative cross-sectional study.
Article in Epilepsy & behavior : E&B, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 37 citations in OpenAlex.
- Reappraisal of the Medical Research Council Antiepileptic Drug Withdrawal Study: Contamination-adjusted and dose-response re-analysis.Epilepsia · 2022Trial
- Neurologists' Views on the Management of Uncontrolled Epilepsy in Spain: A Preliminary Survey.Neurology and therapy · 2026Article
- Benzodiazepines in Epilepsy: A US Perspective on Clinical Use, Pharmacology, Abuse Methods, and Public Health Considerations.Neurology and therapy · 2026Review
- DECREASE study: A European pool-analysis of patients with significant reductions in concomitant antiseizure medications in cenobamate Early Access Programs.Epilepsia open · 2026Article
- Cenobamate: An Appraisal Five Years On.Neurology and therapy · 2026Review
- Polypharmacy burden and incident epilepsy among older adults in the United States.Epilepsia open · 2026Article
- Effectiveness and safety of cenobamate after conversion to monotherapy or dual therapy in real-world clinical practice.Epileptic disorders : international epilepsy journal with videotape · 2026Observational
- Treatment Patterns of Antiseizure Medication for Poststroke Prophylaxis Among Older Adults.Journal of the American Heart Association · 2026Article
- Impact of long-term treatment with cenobamate on concomitant usage of antiseizure medications: A real-world retrospective study in Spain.Epilepsia · 2026Observational
- Comparative analysis of monotherapy versus duotherapy with antiseizure medications for intraoperative and early postoperative seizure control in glioma patients undergoing awake craniotomy.Journal of neuro-oncology · 2025Article
- Achieving epilepsy care for all: Ecosystem-based transformation.Epilepsia · 2025Review
- Cenobamate for Difficult-to-Treat Epilepsy - Selected Case Vignettes.Neuropsychiatric disease and treatment · 2025Article
- The association between active and passive tobacco smoke exposures and epilepsy in United States participants of the National Health and Nutrition Examination Survey (2013-2018).Frontiers in neurology · 2025Article
- Treatment simplification to optimize cenobamate effectiveness and tolerability: A real-world retrospective study in Spain.Epilepsia open · 2024Observational
- Trends in central nervous system-active polypharmacy among people with multiple sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2024Article
- Pharmacokinetic drug-drug interactions of JBPOS0101 mediated by cytochrome P450 3A4 and UDP-glucuronosyltransferases.Clinical and translational science · 2024Article
- Perampanel for Treatment of People with a Range of Epilepsy Aetiologies in Clinical Practice: Evidence from the PERMIT Extension Study.Neurology and therapy · 2024Article
- Potentially inappropriate prescribing in elderly patients with epilepsy at two referral hospitals in Ethiopia.Frontiers in medicine · 2024Article
- Effect of different physical activity training methods on epilepsy: A protocol for systematic review and meta-analysis.Medicine · 2022Article
- Adherence to Antiseizure vs Other Medications Among US Medicare Beneficiaries With and Without Epilepsy.Neurology · 2022Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
objectiveThe objective of the study was to characterize the prevalence of polypharmacy and central nervous system (CNS)-acting medications in patients with epilepsy, and particular types of medications.
methodsThis was a retrospective cross-sectional study using data from the nationally representative National Health and Nutrition Examination Survey (NHANES). We included patients who reported taking at least one prescription medication in order to treat seizures or epilepsy during NHANES survey years 2013-2016. We assessed the number and types of drugs and predictors of total number of medications using a negative binomial regression. We then assessed prevalence of polypharmacy (≥5 medications), CNS polypharmacy (≥3 CNS-acting medications) and additional CNS-acting medications, and drugs that lower the seizure threshold (i.e., bupropion and tramadol), and extrapolated prevalence to estimated affected US population.
resultsThe NHANES contained 20,146 participants, of whom 135 reported taking ≥1 antiseizure medication (ASM) for seizures or epilepsy representing 2,399,520 US citizens using NHANES's sampling frame. Patients reported taking a mean 5.3 (95% confidence interval (CI): 4.3-6.3) prescription medications. Adjusting for race, sex, and uninsurance, both age and number of chronic conditions predicted increased number of medications (incident rate ratio (IRR) per decade: 1.16, 95% CI: 1.04-1.28; IRR per chronic condition: 1.19, 95% CI: 1.11-1.27). Polypharmacy was reported by 47% (95% CI: 38%-57%) of patients, CNS polypharmacy by 34% (23%-47%), benzodiazepine use by 21% (14%-30%), opioid use by 16% (11%-24%), benzodiazepine plus opioid use by 6% (3%-14%), and 6% (2%-15%) reported a drug that lowers the seizure threshold. Twelve percent (7%-20%) took an opioid with either a benzodiazepine or gabapentinoid.
conclusionsPolypharmacy is common in patients with epilepsy. Patients taking ASMs frequently reported also taking other CNS-acting medications (i.e., opioids, benzodiazepines, seizure threshold-lowering medications), and medication combinations with black box warnings. Central nervous system polypharmacy poses health risks. Future research is needed to explore drivers of polypharmacy and strategies to help mitigate potentially harmful prescription use in this high-risk population.
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