Abstracts

To examine our experience with the use of pregabalin as part of the treatment of seizures in adult patients with refractory epilepsy., Since pregabalin (PGB) became available in 2005, all patients prescribed PGB as part of their anti-epileptic drug (AED) regimen by one epileptologist at our center were included in data collection. Patients received standard care at our center, including education, therapy rationale/expectations, instructions, side effects, and follow-up care. PGB and concurrent AED dose titration and adjustments were individualized based on side effects and seizure frequency.
As patients were prescribed PGB, data including seizure type and frequency, current and past exposure to AED[apos]s, and PGB dosing were recorded. The charts of all patients prescribed PGB therapy were retrospectively reviewed in Feb 2006 and in May 2006 by our center[apos]s clinical pharmacist for PGB efficacy, side effects, and reason for discontinuation if applicable., Since Sep 2005, 42 patients have been prescribed PGB as part of their AED regimen. By May 2006, 24/42 (57%) remained on PGB and was discontinued in 18/42 (43%).
All patients were prescribed PGB for seizures; 38/42 (90%) for localization-related and 4/42 (10%) for generalized seizures. At the time PGB was added, 12/42 (29%) were taking [gt]/= 1 AED +/- Vagus Nerve Stimulator (VNS) therapy and 30/42 (71%) were taking [gt]/= 2 AED[apos]s +/- VNS. Previous AED therapy included 4/42 (10%) on [lt]/= 1 AED, 8/42 (19%) on 2-4 AED[apos]s, 28/42 (66%) on 5-10 AED[apos]s, and 2/42 (5%) on [gt]10 AED[apos]s.
The 24 patients continuing PGB as part of their AED regimen as of May 2006 had been taking PGB for a range of 3-8 months. Reported side effects include weight gain in 4/24 (17%), ataxia in 2/24 (8%), and no side effects in 18/24 (75%). Seizure frequency decreased in 6/24 (25%), increased in 4/24 (17%), and did not change in 14/24 (58%).
The 18 patients that discontinued PGB by May 2006 had been taking PGB for a range of 3 days-6 months. Side effects requiring PGB discontinuation include seizure increase in 7/18 (38%); fatigue in 5/18 (27%); ataxia in 2/18 (11%); and headache, weight gain, behavior change, and unfocused thoughts in 1/18 (6%) of each. Overall, seizure frequency decreased in 1/18 (6%), increased in 9/18 (50%), and did not change in 8/18 (44%)., These results characterize our center[apos]s experience with PGB from Sep 2005-May 2006. Overall, our center has experienced limited success using PGB as part of the AED regimen to treat seizures in adult patients with refractory epilepsy. In these patients, a regimen containing PGB may be considered, but patients must be monitored for side effects and effect on seizure frequency. In our experience, PGB has been discontinued in a substantial number of patients for reasons including intolerable side effects and lack of efficacy.,