Abstracts

Rationale: The treatment of epileptic seizures among women of reproductive age represents a special challenge for all physicians. The second generation anti-epileptic medications provide an opportunity to minimize teratogenesis and other pregnancy complications. Therefore, we were interested in assessing the prescribing trends and patterns for one specific AED, levetiracetam, among women of reproductive age at a large, urban hospital.Methods: An outpatient pharmacy database at Parkland Health & Hospital System(Dallas, Texas) was used to identify all adult women of reproductive age (18-50 years old) who were taking a non-benzodiazepine, anti-epileptic medication for any indication. The patient's age was calculated at the time of the last prescription. This study was approved by the University of Texas Southwestern Institutional Review Board (IRB # 122006-049).Results: From January 1, 2003 to April 30, 2007, the outpatient pharmacy database identified 5,434 women taking one or more AEDs, of which 2,504 were women of reproductive age. Among the latter group, there were 2,237 women taking only one AED and 267 were taking more than one AED. There were 185 women taking levetiracetam along with other AEDs and 114 were on levetiracetam monotherapy.Conclusions: An outpatient pharmacy database has been analyzed to assess the AED prescribing patterns among women of reproductive age. Specifically, we identified a substantial number of women on levetiracetam monotherapy, an off-label indication. We are currently cross referencing this pharmacy database with both EEG-Epilepsy and pregnancy databases in order to identify patterns of use among specific subpopulations (e.g., pregnant women, women with various epileptic syndromes). We hope to identify emerging trends of FDA-approved and off-label uses of levetiracetam for this vulnerable population. This study was supported by a grant from UCB.