{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T07:16:11Z","timestamp":1781075771878,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T00:00:00Z","timestamp":1701129600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>In patients with epilepsy and sustained seizure freedom, guidelines recommend considering discontinuation of antiseizure medication (ASM) based on shared decision\u2010making. This study aims to identify factors associated with non\u2010discontinuation of ASM in seizure\u2010free patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective data from three sites of an academic outpatient clinic were analyzed. Adult patients with epilepsy who have been seizure\u2010free for \u226524\u2009months on ASM monotherapy were included. The primary end\u2010point was non\u2010discontinuation of ASM, defined as no discontinuation or no dose reduction of \u226525% at the last outpatient clinic visit in the ultimate seizure\u2010free interval. Secondary end\u2010points included frequency of discussion on discontinuation attempts between patients and physicians, adherence to ASM discontinuation decisions, and post\u2010discontinuation seizure outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 338 included patients, 81.7% did not discontinue ASM and did not reduce its dose, 11.5% discontinued ASM and 6.8% had a significant dose reduction. Factors independently associated with non\u2010discontinuation of ASM were history of focal to bilateral or generalized tonic\u2013clonic seizures (odds ratio [OR] 2.33, 95% confidence interval [CI] 1.08\u20135.06), history of breakthrough seizures (OR 3.32, 95% CI 1.10\u201310.04), history of failed attempts to discontinue or reduce the ASM dose (OR 4.67, 95% CI 1.03\u201321.11) and higher ASM load at the index visit (OR 6.10, 95% CI 2.09\u201317.78). Discontinuation attempts were made during the entire period of seizure freedom and were most commonly undertaken \u226510\u2009years after the last seizure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study provides insights into factors associated with the shared decision\u2010making process regarding ASM discontinuation in seizure\u2010free patients and highlights the importance of considering individual patient characteristics and seizure history.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16160","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T18:58:44Z","timestamp":1701197924000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Non\u2010discontinuation of antiseizure medication in seizure\u2010free epilepsy 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