Abstracts

Rationale: There is a lack of comprehensive data regarding the existing prescription trends for anti-seizure medications among women of reproductive age, especially in resource-restricted settings. As part of our efforts to address this issue, we conducted this study to evaluate the prescription patterns of anti-seizure medications in women of child-bearing age over the last 14 years.

Methods: This retrospective observational study utilized data from the only academic medical center in a resource-limited state with a large catchment area to analyze information from women of childbearing age (18-44 years) who were prescribed anti-seizure medication using deidentified data with Patient Cohort Explorer. The incident cases had an index date between 2010 and 2024. The study described the treatment patterns of anti-seizure medication during the initial and follow-up period.

Results:
577 women of childbearing age who were prescribed an anti-seizure medication were included in the study. The mean age was 28.5 years old. (66.7%) patients were Black or Africo-American, 167 (29%) were white or Caucasian, 4 (0.7%) were MS Band Choctaw Indian, 3 (0.5%) were Asian, 2 (0.35%) were American Indian Native. Out of these, 124 (21%) had a documented history of current or former history of smoking. The most prescribed medications were gabapentin (45%), topiramate (16.9%), levetiracetam (13.4%), clonazepam (8.4%), lamotrigine (4.8%), pregabalin (2.7%), divalproex (1.9%), carbamazepine (1.7%), oxcarbazepine (1.2%), phenytoin (1.0%), and ethosuximide (0.2%). 144 patients had migraine, 64 had peripheral neuropathy, 28 had benign intracranial hypertension, 158 patients had epilepsy/seizures or convulsions and 35 had eclampsia/preeclampsia documented as a diagnosis.









Out of the 577 patients on anti-seizure medications, 184 were pregnant during the study period, out of which 104 had a history of epilepsy/seizures/convulsions. The most common prescribed medications in pregnancy were levetiracetam 91 (49%), gabapentin 87 (47%) followed by lamotrigine 42 (23%), topiramate 33 (18%), clonazepam 21 (11%), pregabalin 17 (9%), phenytoin 16 (9%), carbamazepine 12 (7%), divalproex 8 (4%), oxcarbazepine 6 (3%) and ethosuximide 1 (0.5%).




Conclusions: This study is the first step into providing insight into the prescription patterns of anti-seizure medications in women of childbearing age over the past 14 years in Mississippi. To our knowledge, this is the first study of this kind done in the state of Mississippi. We aim to use this data as a foundation for larger multicenter studies to enhance neurological care for young women in underrepresented and underserved areas.

Funding: None