Evidence map›Paper›PMID 42093832›Full record

ArticleBMJ neurology open2026

A mixed-methods study of patient perspectives on antiseizure medication discontinuation attempts after a period of seizure-freedom.

Samuel W Terman, Jordan M Silva, Max Kuster, Jasper Lee, Amanda Brand, Kara Manuel, Navya Kalia, Micaela Dugan, Marla Reid, Katherine Mortati and 5 more

Abstract read
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In one paragraph

Article in BMJ neurology open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

15 authors.

Samuel W TermanDepartment of Neurology, University of Michigan, Ann Arbor, Michigan, USA.ORCID https://orcid.org/0000-0001-6179-9467
Jordan M SilvaUniversity of Michigan Medical School, Ann Arbor, Michigan, USA.
Max KusterUniversity Department of Neurology, State University of New York Downstate Health Sciences, Brooklyn, New York, USA.
Jasper LeeHackensack Meridian School of Medicine, Nutley, New Jersey, USA.
Amanda BrandHackensack Meridian School of Medicine, Nutley, New Jersey, USA.
Kara ManuelUniversity of Michigan Medical School, Ann Arbor, Michigan, USA.
Navya KaliaUniversity of Michigan Medical School, Ann Arbor, Michigan, USA.
Micaela DuganUniversity of Michigan Medical School, Ann Arbor, Michigan, USA.
Marla ReidUniversity Department of Neurology, State University of New York Downstate Health Sciences, Brooklyn, New York, USA.
Katherine MortatiUniversity Department of Neurology, State University of New York Downstate Health Sciences, Brooklyn, New York, USA.
Alexandra TolmasovUniversity Department of Neurology, State University of New York Downstate Health Sciences, Brooklyn, New York, USA.
James F BurkeDepartment of Neurology, The Ohio State University, Columbus, Ohio, USA.
Chloé E HillDepartment of Neurology, University of Michigan, Ann Arbor, Michigan, USA.
Susanna S OkulaUniversity Department of Neurology, State University of New York Downstate Health Sciences, Brooklyn, New York, USA.
Palak S PatelHackensack Meridian School of Medicine, Nutley, New Jersey, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Antiseizure medications (ASMs) are the standard treatment for epilepsy. Yet because ASMs can have adverse effects and seizure risk decreases with longer seizure-free periods, guidelines have suggested considering ASM withdrawal after a period of seizure-freedom. However, work exploring patient experience with ASM discontinuation is scarce. We explored patient attitudes regarding past or possible future ASM discontinuation attempts. Methods: We conducted a mixed-methods study of adults at least 1 year seizure-free, seen for epilepsy across three institutions. A semistructured interview script assessed views about past or hypothetical future ASM discontinuation attempts. Results: We interviewed 32 participants. Seizure-free duration ranged from 1.0 to 35.0 years (median 2.9, IQR 1.6-11.2). 21 (66%) participants reported having tried to discontinue an ASM in the past due to a period of seizure-freedom. 13 participants (43% of 30 who responded to the question) felt that they would still be glad to have tried discontinuation for the knowledge gained even if it resulted in a seizure. This corresponded to 52% (11/21) of patients who had previously attempted ASM discontinuation due to a period of seizure-freedom, compared with 22% (2/9) of patients who had not previously attempted ASM discontinuation (Fisher's exact test p=0.23). Qualitative responses generally indicated that even a 'failed' discontinuation attempt was 'worth trying' and could support a patient's future decision to remain on long-term ASMs without wondering any longer if they really 'need it.' Conclusions: Even 'failed' discontinuation attempts may have value due to knowledge gained to support subsequent continuation.

Indexed as

EPILEPSY

Identifiers

PMID42093832
PMCPMC13141134

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