Restrictions on Some Anti-Seizure Medications May Create Barriers to Epilepsy Care

Originally published in Epilepsy & Behavior

A recent survey of neurologists found that restrictions on certain anti-seizure medications (ASMs) may make it harder for some people with epilepsy to obtain their medications on time. Some ASMs are classified as controlled substances in the United States, which can result in additional requirements or restrictions on prescriptions, refills, and mail-order delivery. For people with epilepsy, even a short interruption in medication can increase the risk of a breakthrough seizure.

Researchers surveyed 236 neurologists and other clinicians who treat adults with epilepsy. Nearly all respondents—99%—reported having patients whose medication refills were delayed because of controlled-substance restrictions. In addition, 96% reported seeing patients experience breakthrough seizures that they attributed to these restrictions.

In contrast, clinicians reported that misuse of most ASMs was uncommon. The researchers found a particularly large difference between clobazam and traditional benzodiazepines: 8% of respondents reported seeing rare or occasional misuse of clobazam, compared with 79% who reported rare or occasional misuse of traditional benzodiazepines.

The researchers say these findings point to a potential mismatch between the restrictions placed on some ASMs and the frequency of medication misuse seen in epilepsy care. They suggest that policies governing controlled substances should be reconsidered for people with epilepsy, taking into account the potential risks of delayed access to medications.

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