Use of antiepileptic drugs in Estonia:: an epidemiologic study of adult epilepsy

An evaluation of general antiepileptic treatment patterns and utilization of particular drugs was carried out based on the prevalence study of adult active epilepsy in a sample of the Estonian population. The antiepileptic drugs (AEDs) used, and their doses were recorded and compared with clinical characteristics. Nineteen per cent of the subjects did not take any AED on the prevalence day; 83% of those on medication were taking a single drug, 15% two, and 2% three AEDs. Localization-related symptomatic epilepsies were most frequently treated with AEDs and were also the largest group receiving polytherapy. The most common agent was carbamazepine (68%), followed by barbiturates. Valproate and phenytoin were used much less. The study design and its impact on the interpretation of results is discussed. The percentage of sodium-channel blockers is generally comparable with that reported from other European countries. The small share of valproate is probably a result of the extensive utilization of barbiturates, and is partially related to the age distribution in the study. The high figure of AED-free cases, and small percentage of polytherapy indicates a tendency for undertreatment. Some points for improvement in AED therapy are discussed.