Abstracts

Rationale: There is increasing awareness of the need to avoid overtreatment in patients with epilepsy. Our objectives are to describe the characteristics of antiepileptic drug (AED) treatment and to assess the impact of adverse effects (AEs), depressive symptoms and seizure frequency on health-related quality of life (HRQOL) in adults with pharmacoresistant epilepsy. Methods: A prospective evaluation was conducted in consecutive adult outpatients with pharmacoresistant epilepsy at University of São Paulo. Patients were assessed for medical history, seizures rates, epilepsy diagnosis, comorbidities, treatment characteristics including AED load as defined by the prescribed daily dose/defined daily dose ratio (PDD/DDD), AEs, and results of Quality of Life in Epilepsy (QOLIE-31), Beck Depression Inventory (BDI) and Adverse Events Profile (AEP) questionnaires. Results: 102 patients were enrolled (mean age 37 years, range 16-60). Of these, 93% were on polytherapy. The mean PDD/DDD ratio was 3.3 (range 0.6 to 7.7). The AEP, BDI and QOLIE-31 questionnaires were completed by 66 patients and 43 (65%) had an AEP score consistent with a major burden of AEs (≥ 45). Mean scores were 48.9 (SD, 10.3) for AEP, 20.3 (SD, 12.5) for BDI and 52.5 (SD, 18) for QOLIE-31. QOLIE-31 scores correlated inversely with AEP scores (r = - 0.59; p < 0.01), BDI scores (r = - 0.5; p < 0.01), and seizure frequency (r = - 0.43; p < 0.01). There was no significant correlation between AEP scores and AED load (r = 0.13; p < 0.31). Conclusions: In addition to seizure frequency, AEs have a major influence of self-perceived HRQOL in patients with pharmacoresistant epilepsy.