gms | German Medical Science

Background: Treatment of pediatric epilepsy has advanced with the development of new antiepileptic drugs. The European Medicines Agency recommends that more research into pediatric drugs for epilepsy is needed.

Objectives: To characterize utilization of antiepileptic drugs in children with a specific emphasis on newer antiepileptic drugs.

Methods: Data were obtained from the German Pharmacoepidemiological Research Database for the period 2004-2006, including prescription data of more than 14 million insurance members from all over Germany. Descriptive analyses were perfomed to assess prevalence and incidence of antiepileptic drug use stratified by age and sex. Mono- and combination therapy were considered as well as the clinical speciality of the prescribing physician.

Results: We identified 13,197 children who received a total of 226,856 antiepileptic drug dispensations. Of these, 140,992 (62.15%) were conventional and 85,864 (37.85%) were newer antiepileptic drugs. Most commonly prescribed antiepileptic drug was valproic acid (71,436; 31.49%), followed by lamotrigine (33,395; 14.72%), sulthiame (24,765; 10.92%), oxcarbazepine (22,973; 10.13%) and carbamazepine (15,273; 6.73%). One-year prescribing prevalence ranged betweeen 4.10 and 4.11 per 1,000 children. Incidence of antiepileptic drug use was 0.85 (95% CI 0.81 to 0.89) per 1,000 person-years in 2005 and 0.80 (95% CI 0.76 to 0.84) per 1,000 person-years in 2006. Monotherapy (152,926; 67.41%) was found to be more common than combination therapy. Most of the dispensed antiepileptic drugs were prescribed by pediatricians (147,150; 64.86%) followed by general practitioners (44,570; 19.65%) and clinical institutions (11,407; 5.03%).

Conclusions: Conventional antiepileptics were the most commonly prescribed drugs for treatment of childhood epilepsy in Germany. This is in contrast to international studies in adults where newer antiepileptic drugs are reported to have a greater impact on prescribing.