ArticlePharmacoepidemiology and drug safety2021
Patterns of anticonvulsant use and adverse drug events in older adults.
Article in Pharmacoepidemiology and drug safety, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Treatment Patterns of Antiseizure Medication for Poststroke Prophylaxis Among Older Adults.Journal of the American Heart Association · 2026Article
- Choice of antiseizure medications and associated outcomes in Medicare beneficiaries after acute ischemic stroke.Epilepsia · 2025Article
- Differences in patterns of outpatient epilepsy-specific medication initiation after acute ischemic stroke in the Medicare population.Epilepsia · 2025Observational
- Choice of Epilepsy Anti-Seizure Medications and Associated Outcomes in Medicare Beneficiaries.medRxiv : the preprint server for health sciences · 2025Article
- Comparative Effectiveness and Safety of Seizure Prophylaxis Among Adults After Acute Ischemic Stroke.Stroke · 2023Article
- No short-term mortality from benzodiazepine use post-acute ischemic stroke after accounting for bias.Journal of clinical epidemiology · 2023Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
purposeTo examine indications for, duration of use, and rate of adverse drug events (ADE) attributable to anticonvulsant initiation, as adjudicated by expert review of electronic health records (EHR) of older adults.
methodsWe identified a cohort of community dwelling Medicare beneficiaries with linked EHR (aged 65+, continuously enrolled with a large health system/until death between 2012 and 2014, n = 20 945) and drew a stratified EHR review sample (n = 1534). An expert reviewed all records to adjudicate anticonvulsant use, years of use, indication for use, and evidence of ADEs attributable to anticonvulsant initiation. After excluding patients with insufficient EHR data (n = 37; 2%), we reconstructed the cohort using inverse probability weights to resemble the original cohort of eligible beneficiaries (n = 20 380). Among incident users of a single anticonvulsant, we estimated the rate of ADEs and described the type and severity of ADEs.
resultsOverall, 12% (n = 2469) of eligible beneficiaries used at least one anticonvulsant in the 2012 to 2014 period (4% [n = 757] incident users, 8% [n = 1712] prevalent users). Incident users were most frequently prescribed gabapentin (n = 461/757, 61%), benzodiazepines (n = 122/757, 16%), and levetiracetam (n = 74/757, 10%); the most common indication was pain relief (n = 214; 28%) followed by epilepsy (n = 53; 7%). Among incident users, the overall ADE rate was 10/100 person-years (95% CI 4-20/100 person-years), of which 29% (n = 28/97) were life threatening (eg, somnolence). Most ADEs among incident monotherapy users were nervous system related (68%, n = 66/97).
conclusionMany older adult community dwelling traditional Medicare beneficiaries had clinically significant ADEs likely attributable to the initiation of anticonvulsant therapy, which was begun for a range of indications.
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