An analysis of prescription pattern and adverse drug reaction profile in children treated with antiepileptic drugs in a tertiary care teaching hospital

Meenakshi B., Ezhil Ramya J., Ananthy Shri T. R. R.


Background: Epilepsy is a clinical diagnosis made after a child has had two (or) more unprovoked seizures. Ideal goal in the management of childhood epilepsy is complete control with minimal side effects. The incidence of adverse effects is an important issue with antiepileptic drugs (AEDs). We took up this study to analyse the pattern of AEDs prescribed and adverse drug reaction (ADR) profile in children with epilepsy being treated at a tertiary care Teaching hospital of South Tamil Nadu.

Methods: Children of both sexes, 1 to 12 years of age and on AEDs for at least 3 months were included for the study. Patients with febrile seizures, status epilepticus, seizures associated with paralytic stroke, head injury and cerebral palsy were excluded. Demographic data, treatment history and adverse drug events were recorded. Serum liver function tests, complete blood count and peripheral smear and causality analysis of ADRs were done.

Results: Out of 203 patients 122 (60.1%) were males. Average number of AED prescribed per patient was 1.37. About 68% received monotherapy. 26.6% required two drugs and 5.4% patients required triple drugs. Out of 75 ADRs reported 3 are probable and 72 are possible reactions. The prevalence of ADRs (p=0.014*) and anorexia (p=0.0004*) were more in patients on polytherapy.

Conclusions: ADRs were more common in patients with combination therapy which insists the need for a newer AED with less toxicity especially for paediatric patients.


Epilepsy, Antiepileptic drugs, Adverse drug reactions, Prescription pattern

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Bansode A, Zad V, Sawant S, Dudhal K. Awareness about Pharmacovigilance among Resident Doctors in a Tertiary Care Hospital. Journal of Evolution of Medical and Dental Sciences. 2015;4(2):207-10.

Camfield PR, Camfield CS. Pediatric Epilepsy: An Overview. In: Kenneth F. Swaiman, Stephen Ashwal, Donna M. Ferriero eds. Paediatric Neurology Principles and Practice. 4th ed. Mosby Elsevier. 2006:981-1005.

Kalra V. Seizure Disorders in Children. In: IAP Textbook of Pediatrics. 3rd ed. 2006:322-28.

Bootsma HP, Ricker L, Diepman L. Long-term effects of levetiracetam and topiramate in clinical practice: A head-to-head comparison. Seizure. 2008;01:79-93.

Mc Namara JO. Pharmacotherapy of epilepsies. In: Laurence Brunton, Bruce Chabner, Bjorn Knollman.eds. Goodman & Gilman’s The Pharmacologic basis of therapeutics.12th ed. Mc Graw-Hill. 2011:583-607.

Lowenstein DH. Seizures and epilepsy In: Longo, Fauci, Kasper, Hauser, Jameson, Loscalzo eds. Harrison’s Principles of Internal Medicine 18th ed. Mc Graw-Hill; 2012:3251-3270. WHO-UMC causality assessment - Uppsala Monitoring Centre. Available at

Hasan SS, Bahari MB, Babar ZU, Ganesan V. Antiepileptic Drug Utilization and Seizure Outcome among Paediatric Patients in a Malaysian Public Hospital. Singapore Med J. 2010;51:21-7.

Ball DE, Taderera A. Development of Drug Use Indicators for Epilepsy. Cent Afr J Med. 2003:49(12):134-8.

Shah PA, Shapoo SF, Koul RK, Khan MA. Prevalence of Epilepsy in School-going Children (6-18 Years) in Kashmir Valley of North-west India. J Indian Med Assoc. 2009;107(4):216-8.

Udani VP, Dharnidharkari V, Nair A, Oka M. Difficult to control epilepsy in childhood-a long term study of 123 cases. Indian Pediatr. 1993;30:1199-206.

Porter RJ, Meldrum BS. In: Antiseizure drugs. Bertram G. Katzung, Susan B. Masters, Anthony J. Trevor eds Basic and clinical Pharmacology 12th ed. 2012;403-427.

Mc Auley JW, Lott RS. Seizure disorders. In: Mary Anne Koda-Kimble eds. Applied Therapeutics. The clinical use of drugs 9th ed. 2009;54:1-37.

Conway JM, Kriel RL, Birnbaum AK. Antiepileptic drug therapy in children. In: Kenneth F. Swaiman, Stephen Ashwal, Donna M. Ferriero eds. Paediatric Neurology Principles and Practice. 4th ed. Mosby Elsevier. 2006:981-1005.

Arnold F, Parasuraman S, Arokiasamy P, Kothari M. Nutrition in India, in National Family Health Survey (NFHS-3) India. 2009. Available at

bsite_18sep09.pdf. View at Google Scholar.