Flexible Drug Dosing Produces Less Side-Effects in People with Epilepsy

For the first time, researchers compared dosing regimens of an antiepileptic drug (AED) used for treatment of partial epilepsy in adults, in conjunction with other AEDs. They looked at dosing used in clinical everyday life (flexible dosing) and that used in classical clinical trials (fixed dose) and discovered that the flexible dosing method was superior. The study is published in Epilepsia, the official journal of the International League Against Epilepsy.

Researchers observed how patients responded to these two methods of dosing therapy over a 12-week period. According to the researchers, while clinical trials have traditionally used fixed doses throughout a treatment period, clinical practice allows for the gradual adjustment of medication dose to enhance patient tolerability and enable optimum effective dosing, based on individual patient response.

Results showed that both regimens were highly effective in reducing seizure frequency in patients who were refractory to treatment. However, “the ability to adjust the dose also permitted the patients to remain on this particular AED (pregabalin) longer since they experienced fewer side-effects and did not drop out of the study (76% for flexible dose versus 58% for fixed dose completed the study),” states lead researcher, Christian Elger. “It also shows that studies copying the clinical picture of epilepsy treatment give more realistic data on the balance between efficacy and tolerability of an antiepileptic drug.”

The study demonstrates a significant clinical advantage in treating patients with epilepsy when their dose is adjusted according to the individual patient.