A PRACTICAL GUIDE TO DISCONTINUING ANTIEPILEPTIC DRUGS

Up to 70% of those individuals who develop epilepsy achieve remission from seizures for a period of 2 or more years. On average about 30% of those who are withdrawn from antiepileptic drug treatment will experience further seizures within 2 years. Patients with childhood onset epilepsy that is not symptomatic and that is associated with a normal electroencephalogram at the time of drug withdrawal are at the lowest risk of seizure recurrence. In contrast, juvenile myoclonic epilepsy is a contraindication to drug withdrawal. The risk of seizure recurrence appears to decrease with increasing length of remission (up to 5 years) before consideration of drug withdrawal. A prognostic model has been developed that is based on information from the largest randomised study of antiepileptic drug withdrawal. This may be a useful informational tool to aid decision making in this area.