{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:06:28Z","timestamp":1753891588751,"version":"3.41.2"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We evaluate the effect of distinct clinical features on anti-seizure medication (ASM) doses in seizure-free and not seizure-free patients aged \u226516 years with new-onset epilepsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>This study included 459 patients with a validated diagnosis of epilepsy. The most prescribed ASMs were oxcarbazepine (OXC; <jats:italic>n<\/jats:italic> = 307), followed by valproic acid (VPA; <jats:italic>n<\/jats:italic> = 115), carbamazepine (CBZ; <jats:italic>n<\/jats:italic> = 81), and lamotrigine (LTG; <jats:italic>n<\/jats:italic> = 67). The seizure freedom rate with their first or subsequent ASM was 88.0%. A retrospective analysis of patient records was performed to determine any association between doses of ASMs and patient characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median OXC dose in seizure-free patients aged &amp;gt;60 years was 600 mg compared to 900 mg in younger patients. When controlling for age but not in an unadjusted model, the median dose of OXC was lower (300 mg, <jats:italic>p<\/jats:italic> = 0.018) for seizure-free patients compared to non-seizure-free patients, and the median dose of OXC was also 300 mg lower among older patients aged &amp;gt;60 years (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). The median OXC doses for men aged \u226460 years were 300 mg higher than for women aged &amp;gt;60 years (900 mg vs. 600 mg, <jats:italic>p<\/jats:italic> = 0.021). The median dose of VPA was 400 mg higher in men than in women (<jats:italic>p<\/jats:italic> &amp;lt; 0.001) and 400 mg higher in not seizure-free patients compared to seizure-free patients only when adjusting for sex (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). Higher median doses for CBZ were registered with FAS compared with FBTCS (difference in median doses of 200 mg; <jats:italic>p<\/jats:italic> = 0.017).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Significant OXC dose differences were detected between age groups, whereas VPA dosing was different in men and women. Moreover, CBZ doses were dependent on some seizure types. These data allow for the individualization of the initial target dosing based on key clinical characteristics.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1159339","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T14:45:08Z","timestamp":1691419508000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of clinical features on antiseizure medication doses in patients with newly diagnosed epilepsy"],"prefix":"10.3389","volume":"14","author":[{"given":"Hire","family":"Hersi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jukka","family":"Peltola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jani","family":"Raitanen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jukka T.","family":"Saarinen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1111\/j.1528-1167.2009.02397.x","article-title":"Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE commission on therapeutic strategies","volume":"51","author":"Kwan","year":"2010","journal-title":"Epilepsia."},{"key":"B2","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1111\/ane.13426","article-title":"Response to first antiseizure medication in patients diagnosed with epilepsy","volume":"144","author":"Hersi","year":"2021","journal-title":"Acta Neurol Scand."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1042168","DOI":"10.3389\/fneur.2022.1042168","article-title":"Response to subsequent antiseizure medications after first antiseizure medication failure in newly diagnosed epilepsy","volume":"13","author":"Hersi","year":"2022","journal-title":"Front Neurol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1001\/jamaneurol.2015.4515","article-title":"Efforts in epilepsy prevention in the last 40 years: lessons from a large nationwide study","volume":"73","author":"Sillanp\u00e4\u00e4","year":"2016","journal-title":"JAMA Neurol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/S1474-4422(19)30430-2","article-title":"Unravelling the heterogeneity of epilepsy for optimal individualised treatment: advances in 2019","volume":"19","author":"Pennell","year":"2020","journal-title":"Lancet Neurol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.eplepsyres.2005.07.017","article-title":"Pharmacological and clinical aspects of antiepileptic drug use in the elderly","volume":"68","author":"Perucca","year":"2006","journal-title":"Epilepsy Res."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2208","DOI":"10.1111\/bcp.13653","article-title":"New-onset epilepsy in the elderly","volume":"84","author":"Vu","year":"2018","journal-title":"Br J Clin Pharmacol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"108450","DOI":"10.1016\/j.yebeh.2021.108450","article-title":"Prescription patterns and dosages of antiepileptic drugs in prevalent patients with epilepsy in Taiwan: a nationwide retrospective cross-sectional study","volume":"126","author":"Liang","year":"2022","journal-title":"Epilepsy Behav."},{"key":"B9","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.seizure.2018.08.001","article-title":"Randomized controlled trials of antiepileptic drugs for the treatment of post-stroke seizures: a systematic review with network meta-analysis","volume":"61","author":"Brigo","year":"2018","journal-title":"Seizure."},{"key":"B10","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1111\/j.1528-1157.1994.tb02448.x","article-title":"Impact of valproate and phenytoin on cognitive function in elderly patients: results of a single-blind randomized comparative study","volume":"35","author":"Craig","year":"1994","journal-title":"Epilepsia"},{"key":"B11","doi-asserted-by":"publisher","first-page":"682","DOI":"10.1136\/jnnp.57.6.682","article-title":"multicentre comparative trial of sodium valproate and carbamazepine in adult onset epilepsy. 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