May 9, 2012 -- Half of all epilepsy patients who are initially started on one anti-seizure drug remain seizure-free for at least a year, a new study confirms.
Among patients followed for as long as 26 years, initial response to drug treatments strongly predicted future seizure control.
Yet less than 1% of patients who failed to respond to three anti-seizure drug regimens achieved adequate seizure control on subsequent drug treatments even though some were treated with as many as nine different drugs or drug combinations.
The findings make it clear that epilepsy patients who are candidates for surgery or other non-drug treatments should be considered for these procedures earlier rather than later, says neurologist Patricia E. Penovich, MD, of the University of Minnesota and the Minnesota Epilepsy Group in St. Paul.
"These patients don't have to wait until they have failed five or six different drug regimens," she tells WebMD. "If their seizures are not controlled by the first few medications it is reasonable to consider surgery."
Roughly 2.7 million Americans have epilepsy, and about 1 in 10 people will experience a seizure at some point in their lifetime, according to the Epilepsy Foundation.
More than a dozen different drugs can be used to control seizures, and decisions about which medication to try first are made by considering individual patient characteristics, including age, sex, seizure type, and financial circumstance.
The new research is among the first to examine long-term outcomes in newly diagnosed patients, says researcher Patrick Kwan, MD, PhD, of Australia's University of Melbourne.
The study included about 1,100 epilepsy patients in Scotland and followed them from their first drug treatment for as few as two years and as many as 26 years.
Patients were considered seizure-free if they had no seizures for at least a year without changing their drug regimen.
If seizures continued, a second drug was given, either alone or in combination with the first. And if seizures still were not controlled, different drugs or drug combinations were tried, with some receiving up to nine different drug regimens.