Exit Strategy: Balancing the Risks and Rewards of Antiseizure Medication Withdrawal

Marian Galovic*, Carolina Ferreira-Atuesta, Lara E. Jehi, Kees P.J. Braun, Samuel W. Terman

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

The majority of people with epilepsy achieves long-term seizure-freedom and may consider withdrawal of their anti-seizure medications (ASMs). Withdrawal of ASMs can yield substantial benefits but may be associated with potential risks. This review critically examines the existing literature on ASM withdrawal, emphasizing evidence-based recommendations, where available. Our focus encompasses deprescribing strategies for individuals who have attained seizure freedom through medical treatment, those who have undergone successful epilepsy surgery, and individuals initiated on ASMs following acute symptomatic seizures. We explore state-of-the-art prognostic models in these scenarios that could guide the decision-making process. The review underscores the importance of a collaborative shared-decision approach between patients, caregivers, and physicians. We describe the subjective and objective factors influencing these decisions and illustrate how trade-offs may be effectively managed in practice.

Original languageEnglish
Pages (from-to)150-155
Number of pages6
JournalEpilepsy Currents
Volume24
Issue number3
DOIs
Publication statusPublished - 1 May 2024

Keywords

  • acute symptomatic seizure
  • antiseizure medication
  • deprescribing
  • epilepsy
  • prognostic model
  • seizure
  • seizure-free
  • surgery
  • withdrawal

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