Rationale:
Complementary and alternative medicines (CAM) are increasingly used by patients in the Western world. Although many believe CAM to be benign, there are unique sets of side effects that need to be considered including lowering seizure threshold and interactions with anti-seizure medications (ASMs). Despite the growing body of literature, the frequency of use and the clinical impact that CAM has on people with epilepsy (PWE) remains highly variable in studies. Moreover, studies have suggested that only 31% of PWE who use CAM disclose this to their neurologists. The goal of this project was to evaluate the frequency of CAM use in PWE of different severity.
Methods:
We used data from the National Health Information Survey (NHIS) from 2017 (the most recent year from which data were available that queried participants about epilepsy and CAM). The NHIS surveyed 26,742 participants in 50 states and the District of Columbia, representing 246 million individuals, about a wide variety of health conditions and experiences. Similar to the CDC, we defined “active epilepsy” as self-reported diagnosis of a seizure disorder or epilepsy and either: self-reported use of medication to treat seizures, or having had ≥1 seizure in the past year. The NHIS asked participants about naturopathy, homeopathy, chelation, and traditional non-Western medicine practices. We considered any use of these traditions to be CAM. In addition, the NHIS collects responses about meditation practices, and traditional mind-body practices (yoga, Tai Chi, and Qi Gong).
We used chi-square comparisons and logistic and ordinal regression to compare self-reported CAM, meditation, and traditional mind-body practices use in people with and without epilepsy (PWE; PWoE). We adjusted results for age, sex, race, Hispanic ethnicity, and socioeconomic status.
Results:
A larger percentage of PWE than PWoE use CAM (4.7% vs 3.2%); however, after accounting for the sampling methodology this was not statistically different (p=0.211). CAM use was more common among PWE who experienced more than 3 seizures per year compared to those with controlled epilepsy (8.5% vs 2.9%). Meditation was equally prevalent amongst PWE and PWoE (14.9% vs 15.3%; p=0.102; adjusted OR 0.85, CI 0.61-1.21, p=0.391). People with epilepsy were less likely to practice yoga, Tai Chi, or Qi Gong than were PWoE (10.4% vs 14.6%; adjusted OR 0.60, CI 0.37-0.98, p=0.041). While depression was more common in PWE than in PWoE (16.7% vs 6.7%; p< 0.001), it did not affect the use of CAM.