Changing trends in antiepileptic drug prescribing in girls of child-bearing potential

• Published in: Archives of disease in childhood Vol. 94; no. 6; pp. 443 - 447
• Main Authors: Ackers, R, Besag, F M C, Wade, A, Murray, M L, Wong, I C K
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01-06-2009; BMJ Publishing Group; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Abnormalities, Drug-Induced - prevention & control; Adolescent; Adolescents; Age; Anticonvulsants; Anticonvulsants - adverse effects; Anticonvulsants - therapeutic use; Biological and medical sciences; Carbamazepine - therapeutic use; Child; Children & youth; Confidence intervals; Contraceptive Agents - administration & dosage; Demographic aspects; Dosage and administration; Drug dosages; Drug Interactions; Drugs; Epilepsy; Epilepsy - drug therapy; Ethics; Female; Females; Forecasts and trends; Gender; General aspects; Humans; Market trend/market analysis; Maternal age; Medical sciences; Miscellaneous; Narcotics; Observational studies; Offspring; Practice Patterns, Physicians' - trends; Pregnancy; Prescribing; Prescription drugs; Prescriptions (Drugs); Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Regression (Statistics); Teenagers; Trends; Triazines - therapeutic use; Valproic Acid - therapeutic use; United Kingdom; United Kingdom > UK; Human; Drug; Pediatrics; Medical prescription; Trend; Female; Anticonvulsant; Change; Child; Public health
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.2008.144386

Objective:To characterize trends in prescribing carbamazepine (CBZ), sodium valproate (VPA) and lamotrigine (LTG) in adolescent females in the UK and to examine possible reasons for changing trends.Design:Population-based observational study.Setting:UK General Practice Research Database between 1 January 1993 and 31 December 2006.Patients:12–18-year-old subjects who were issued ⩾1 CBZ, VPA or LTG prescription.Main outcome measures:Prescribing prevalences stratified by age, gender and antiepileptic drug.Results:5417 patients (47.6% females) were prescribed 147 111 prescriptions for CBZ (34.5%), VPA (38.6%) or LTG (26.9%). The prevalence of LTG prescribing in females increased from 0.08 (95% CI 0.04 to 0.12) to 0.80 (95% CI 0.70 to 0.89) per 1000 female population. Conversely, the prevalence in females of CBZ and VPA prescribing significantly decreased from 1.00 (95% CI 0.85 to 1.15) to 0.51 (95% CI 0.44 to 0.58) and from 0.94 (95% CI 0.80 to 1.09) to 0.63 (95% CI 0.55 to 0.72), respectively. This 10-fold rise in LTG prescribing in females is much higher than the fivefold rise in males from 0.09 (95% CI 0.05 to 0.14) to 0.47 (95% CI 0.40 to 0.54) per 1000 male population.Conclusion:The practice of prescribing antiepileptic drugs in adolescents has changed gradually over the last decade. More females aged 12–18 years are prescribed LTG than CBZ or VPA and the increase is much greater than for males. The increase in LTG prescribing mirrors a corresponding decrease in both VPA and CBZ. Concerns about potential problems to offspring appear to be affecting prescription trends in adolescent females of child-bearing potential.