Up to half of patients with epilepsy may not take their antiepileptic drugs (AEDs) as directed (noncompliance), and over half of the patients seen in emergency rooms because of recurrent seizures are noncompliant. Both patient-related and iatrogenic factors may be responsible.
Clear communication with the patient provides the basis for an effective patient-physician partnership, and noncompliance often results from a failure in communication. But even when the physician has given clear instructions and stressed the importance of following the medication regimen, noncompliance is the most common reason for incomplete seizure control or variable side effects.
Factors that increase noncompliance
Patient-related factors that increase noncompliance are:
Iatrogenic factors include:
Signs of noncompliance
Noncompliance should be suspected if there is:
Monitoring AED levels will help determine compliance. However, patients who are compliant with the regimen also may have low or variable serum levels if:
Adapted from http://professionals.epilepsy.com/page/9steps_step5.html and Schachter SC. Treatment of seizures. In: Schachter SC, Schomer DL, eds. The comprehensive evaluation and treatment of epilepsy. San Diego, CA: Academic Press; 1997. p. 61-74. With permission from Elsevier (www.elsevier.com).
Topic Editor: Steven C. Schachter, MD. Last Reviewed: 5/10/08
© 2014 Epilepsy.com. All rights reserved.