Epilepsy Patients Say Seizures Under Control
Survey finds many want more help with drugs' side effects
TUESDAY, Dec. 7, 2004 (HealthDayNews) -- While most people with epilepsy report that their anti-seizure medications work, many say the accompanying side effects limit them in their daily lives.
In a new online survey of 367 adults with epilepsy, 85 percent said they were satisfied with their medicine's ability to control their seizures; 58 percent of them were taking one such medication and 42 percent were taking more than one.
However, nearly two-thirds of the respondents, whose ranged in age from 19 to 58, said their "current health situation limits them from living the life they want to life." Some of the most common repercussions of anti-seizure medications include sleepiness and slowed mental functioning.
Half of those surveyed said that having epilepsy prevented them from participating in at least one routine activity as much as they would like, including driving (37 percent), working (34 percent), exercising or playing sports (25 percent), and traveling (21 percent).
Further, 47 percent of respondents said their doctors focused primarily on seizure control and were less likely to discuss the possible side effects of their treatment.
"Patients are happy with seizure control, but they have concerns about having side effects, and there is a feeling that these concerns are not being followed by doctors," said Dr. Kevan VanLandingham, an associate professor of neurology at Duke University Medical Center.
VanLandingham is a consultant to Eisai Inc., the Japanese pharmaceutical company that sponsored the survey and last spring introduced the FDA-approved anti-seizure medication Zonegran to the U.S. market.
The survey, conducted by Harris Interactive, was released Dec. 7 in conjunction with the start of a new Web site, also sponsored by Eisai Inc., that addresses medical, physical, and emotional facts surrounding the disease.
Epilepsy is a neurological condition affecting how brain cells communicate with each other, and when connections between the cells break down, sufferers can experience small blackouts or seizures. About 2.3 millions Americans suffer from the disease, for which there is no cure.
Instead, medicine has focused on preventing the effects of the disease, primarily by stopping seizures. In the past 10 years, doctors say, there has been a welcome increase in effective anti-seizure medicines, so that now most patients are able to have their seizures controlled and are looking for which medicines will have fewer side effects.
"This is a very important topic. All the medicines have the same potency for the main criteria of seizure control, so the question is, 'Which one fits which patient?'" said Dr. Gholam Motamedi, director of epilepsy at Georgetown University Medical Center. "We hear this question quite a lot."
The anti-seizure medicines used today are "indiscriminate," Motamedi explained. When they enter the body, they interact not only with the neurons that are affecting the seizures but also other neurons that affect other functions.
"There is no absolute criteria" to help doctors choose which medicines cause which side effects, Motamedi said. Also, patient's responses to the medicines are very individual; a drug that causes sleepiness in one patient might not affect another patient at all. So often choosing the best medicine for a patient is a matter of trial and error.
However, Motamedi said, usually patients adjust to their medicines and have little problem with side effects.
"We start them gradually on a low dose, and the patient develops tolerance so that in the majority of cases, the side effects go away," he said, a process that takes from a few days to a few weeks.
He said only between 2 percent to 5 percent of his patients have continuing problems with side effects and was surprised at the high numbers reported in the survey.
Information about medications that treat epilepsy can be found at the Epilepsy Foundation.