To stop or not to stop the AED

摘要: Lossius MI, Hessen E, Mowinckel P, Stavem K, Erikssen J, Gulbrandsen Gjerstad L. Epilepsia 2008;49:455–463.  OBJECTIVE: Despite side effects associated with the use of antiepileptic drugs (AEDs), withdrawal AEDs remains controversial, even after prolonged seizure freedom. The main objective this study was to assess AED on cognitive functions, relapse, health-related quality life (HRQOL), and EEG results. Additionally, potential predictors for freedom from seizures were studied. METHODS: Patients, seizure-free more than 2 years monotherapy, recruited a controlled, prospective, randomized, double-blinded lasting 12 months, or until relapse. Patients randomized (n = 79) nonwithdrawal 81) groups. examination program included clinical neurological examinations, neuropsychological testing, EEG-recordings, cerebral MRI, assessments HRQOL. Follow-up data relapse also collected beyond 12-month period (median 47 months). RESULTS: Seizure at months occurred in 15% group 7% (RR 2.46; 95% CI: 0.85–7.08; p 0.095). After withdrawal, rates 27% median 41 off medication. A normal result all 15 tests increased significantly 11% 28% postwithdrawal. We found no significant EEG. Predictors remaining AED-withdrawal over 1 year carbamazepine prior withdrawal. CONCLUSION: Seizure-free epilepsy patients monotherapy who taper their medication may improve performance relative risk 2.46, compared those continuing therapy.