The University of Minnesota Epilepsy Research and Education Program published two studies evaluating the use of antiepileptic drugs (AEDs) among nursing home (NH) elderly. The studies used a large, nongovernmental data set for studying this population. This chapter is a summary of those two studies. In the first study, a 1-day point prevalence study, 10.5% of the NH residents had one or more AED orders, a prevalence 10 times greater than that found in the community. In a multivariate analysis of factors associated with AED treatment, seizure indication was the most important factor, and age was inversely related to AED use. Phenytoin was the most commonly used AED, followed by carbamazepine, phenobarbital, and valproic acid. The most frequently used combination was phenytoin and phenobarbital. In the second study, evaluating NH admission data, 8% of newly admitted residents were already receiving one or more AEDs when they entered the NH. Factors associated with AED use in this group included epilepsy/seizure disorder, age, cognitive performance, and manic depression (bipolar disease). Among residents recently admitted who were not using an AED at entry, 3% were initiated on an AED within 3 months of admission. Among the factors associated with the initiation of AEDs during this period, the strongest association was with epilepsy/seizure disorder. Manic depression (bipolar disease) was also significantly associated with initiation of an AED after admission. In this group, there was an inverse relationship between age and initiation of an AED.
|Original language||English (US)|
|Title of host publication||The Neurobiology of Epilepsy and Aging|
|Editors||Eugene Ramsay, James Cloyd, Kevin Kelly, Ilo Leppik, Emilio Perucca|
|Number of pages||18|
|State||Published - 2007|
|Name||International Review of Neurobiology|
Bibliographical noteFunding Information:
This research was supported in part by NIH grants to the Epilepsy Clinical Research Program, NIH, NINDS P50‐NS16308, and NINDS 2P50‐NS 16308‐22A1, Ilo Leppik, MD, Principal Investigator. The University of Minnesota Epilepsy Research and Education Program includes four projects, of which one is the Project on Pharmacoepidemiology of Antiepileptic Drugs, Judith Garrard, PhD, Project Principal Investigator.