Evidence map›Paper›PMID 41323357›Full record

ArticleEpilepsy & behavior reports2025

Network analysis of antiseizure medication use, efficacy, and safety in epilepsy: A retrospective cohort study in a tertiary care center.

Miguel Angel Morales-Morales, Emilio García-Gómez, Daniel San-Juan, Carlos Trenado, Daniela Carolina Pimentel-Saona, Yazmin Palomares-Salazar, Manuel Alejandro Del Río-Quiñones, Mónica Alejandra Montalvo-Hérnandez, Christopher De Jesús-Fernández, Jesús Iván Ruiz-Gutierrez and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Epilepsy & behavior reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Miguel Angel Morales-MoralesEpilepsy Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
Emilio García-GómezEpilepsy Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
Daniel San-JuanEpilepsy Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
Carlos TrenadoInstitute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
Daniela Carolina Pimentel-SaonaEpilepsy Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
Yazmin Palomares-SalazarEpilepsy Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
Manuel Alejandro Del Río-QuiñonesHead of Outpatient Clinics. National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
Mónica Alejandra Montalvo-HérnandezFaculty of Medicine, Autonomous University of Puebla, Mexico.
Christopher De Jesús-FernándezFaculty of Medicine, Autonomous University of Puebla, Mexico.
Jesús Iván Ruiz-GutierrezFaculty of Medicine, University of Guadalajara, Mexico.
Clio RubinosNeurocritical Care and Epilepsy, Department of Neurology, University of North Carolina at Chapel Hill, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Antiseizure medications (ASMs) remain the cornerstone of epilepsy treatment, yet data on prescription patterns, effectiveness, and safety in low- and middle-income countries are limited. This retrospective cohort study analyzed changes in ASM use, efficacy, and adverse effects across 10 years in a tertiary care center in Mexico, comparing two phases: 2011-2013 (n = 100) and 2021-2023 (n = 128). Data on seizure freedom, adverse effects, and ASM patterns were analyzed using descriptive statistics and comparative tests. Network analysis and centrality measures were performed with MATLAB Version 9.12.0 to explore the relationships among prescribed ASMs and their influence on outcomes. A total of 228 patients were included. Seizure freedom rates increased from 9 % in the first phase to 25.8 % in the second (p = 0.001). Valproic acid remained the most frequently prescribed ASM, while levetiracetam use markedly increased (49 %). Adverse effects rose from 10 % to 17 % despite a modest reduction in polytherapy (93 % to 87.5 %). The network analysis revealed clusters of ASMs commonly prescribed together that were associated with seizure freedom (valproic acid, lamotrigine, topiramate), whereas combinations including phenobarbital and lamotrigine were linked to more adverse effects. Valproate continues to play a key role in seizure control due to its efficacy, accessibility, and broad-spectrum profile. Despite advances in newer ASM use and improved seizure outcomes, adverse effects remain a concern. Continued monitoring of ASM combinations is warranted to better understand evolving treatment patterns and guide epilepsy management in resource-limited settings.

Indexed as

Antiseizure medicationsDrug safetyEpilepsyNetwork analysisPrescription patterns

Identifiers

PMID41323357
PMCPMC12662108

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.