How often is medication taken as prescribed?

Article Abstract:

Physicians are acutely aware that patients often do not follow instructions for the use of medications. Various reviews of patient compliance have estimated this problem at anywhere between 20 to 82 percent. Differences in experimental design probably account for the wide range of results, and thus the medical community is left with no concrete conclusion regarding patient drug compliance. This issue is important in determining proper dosage during clinical trials where dose, level and duration of effect are important aspects of the data analysis. In some illnesses and chronic conditions ranging from infections of the middle ear (otitis media) to diabetes, the success or failure of treatment is strongly tied to compliance. Unlike some lingering, chronic conditions, patients with epilepsy require constant and carefully controlled medication to avoid seizures which can occur without warning. The risk of seizure carries with it profound social and medical effects such as embarrassment, medical re-evaluation and loss of a driver's license or job. Even with all this riding on proper drug maintenance, the attitude toward medication on the part of patients with epilepsy is not different from the general population. Using epilepsy as a model, both patients recently diagnosed and those having been on drug therapy long-term were measured for compliance using a new computer-driven pill box. The device, a Medication Event Monitor system, produced by Aprex Corporation of Fremont, California, records each time the bill box is opened, presumably to dispense the medication. The device is battery-driven and fits on a standard pill bottle. During the 3,428 days observed, the level of compliance averaged 76 percent and depended on the number of times per day that the drug was to be taken. Compliance was 87 percent for once daily, 81 percent for twice, 77 percent for three times and 39 percent for four times. The level of drug in the patient's blood did not correlate to the rate of compliance (i.e., a dip in the patient's blood level did not produce a change in compliance). This new technique has allowed the detection of levels of compliance which could not be detected by either pill count methods or measurements of blood serum levels in the blood of this patient group.

Research, Patient compliance, Pharmaceutical research

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A comparison of valproate with carbamazepine for the treatment of complex partial seizures and secondarily generalized tonic-clonic seizures in adults

Article Abstract:

Carbamazepine may be more effective than valproate for treatment of partial seizures in epilepsy patients, and may cause fewer long-term side effects. Epilepsy patients are vulnerable to partial or generalized seizures that are very disabling, if not controlled. Of 206 epilepsy patients with partial seizures, 100 were treated with carbamazepine and 106 were treated with valproate. Carbamazepine was more effective than valproate in reducing the frequency and intensity of partial seizures. Among 274 patients with generalized seizures, 136 were treated with valproate and 138 were treated with valproate. Carbamazepine and valproate were equally effective in decreasing the frequency and intensity of generalized seizures. Patients treated with valproate experienced side effects such as weight gain, hair loss or change in texture and tremor more often than those treated with carbamazepine. Individuals treated with carbamazepine were more likely to develop a rash than those treated with valproate.

Health aspects, Valproic acid, Seizures (Medicine), Carbamazepine

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Lamotrigine for generalized seizures associated with the Lennox-Gastaut syndrome

Article Abstract:

The anticonvulsant drug lamotrigine may reduce the frequency of seizures in Lennox-Gastaut syndrome. This syndrome is a severe form of childhood epilepsy that is difficult to treat. High doses of antiepileptic drugs often produce toxic reactions in these patients. Researchers randomly assigned 169 patients to receive lamotrigine or placebo in addition to their regular epilepsy medication. Overall, treated patients had a 32% reduction in major seizures, compared to a 9% reduction in controls. Lamotrigine caused few adverse reactions in these patients, and may be an effective treatment for this syndrome.

Evaluation, Product/Service Evaluation, Lamotrigine, Lamictal (Medication)

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