{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T19:32:07Z","timestamp":1774467127839,"version":"3.50.1"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:00:00Z","timestamp":1724371200000},"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>Background<\/jats:title><jats:p>The management of epilepsy is mainly based on antiseizure medications (ASMs). More than 20 ASMs have been introduced in clinical practice, providing a multitude of prescription choices. To date, there are no published data on the trends in ASMs prescriptions in Morocco. Therefore, we conducted a survey among practicing neurologists in seven tertiary referral hospitals in Morocco to study the current ASMs prescription preferences and their modifying factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Our descriptive and analytical cross-sectional study was based on a survey sent between January and April 2022 to neurologists practicing in seven tertiary referral hospitals in Morocco. Information regarding the prescription of ASMs was collected using an exploitation form and analyzed using the SPSS version 13 software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on questionnaire responses, our results showed that Valproic acid (96.3%) and Lamotrigine (59.8%) were the two most prescribed ASMs for generalized seizure types. For focal seizure types, Carbamazepine (98.8%) and Levetiracetam (34.1%) were the most commonly prescribed drugs, whereas for combined focal and generalized seizure types, the combination of Valproic acid and Carbamazepine (38.55%) was the most prescribed. Phenobarbital was the most commonly prescribed ASM for status epilepticus (40.2%). These prescription preferences were mainly due to seizure types, cost, health insurance coverage, years of experience, and additional epileptology training (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results show a shift in the prescription of ASMs in Morocco. Similar to many other countries, valproic acid and carbamazepine are considered the first-line treatments for generalized and focal seizure types. Some factors remain as major challenges in enhancing epilepsy management in Morocco.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1435075","type":"journal-article","created":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T14:44:50Z","timestamp":1724424290000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Anti-seizure medication prescription preferences: a Moroccan multicenter study"],"prefix":"10.3389","volume":"15","author":[{"given":"Yahya","family":"Naji","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wafa","family":"Hrouch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Laadami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nawal","family":"Adali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,8,23]]},"reference":[{"key":"ref1","year":"2010"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2164","DOI":"10.1111\/j.1528-1167.2012.03661.x","article-title":"Epilepsy-related mortality is low in children: a 30-year population-based study in Olmsted County","volume":"53","author":"Nickels","year":"2012","journal-title":"MN Epilepsia"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1055\/s-0040-1719069","article-title":"Epilepsy: workup and Management in Adults","volume":"40","author":"O'Dwyer","year":"2020","journal-title":"Semin Neurol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1016\/S0140-6736(18)32596-0","article-title":"Epilepsy in adults","volume":"393","author":"Thijs","year":"2019","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1159\/000503831","article-title":"The epidemiology of epilepsy","volume":"54","author":"Beghi","year":"2020","journal-title":"Neuroepidemiology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"001","DOI":"10.1055\/s-0043-1761630","article-title":"Epilepsy diagnosis delay in a tertiary hospital center: what facts, for what reasons?","volume":"8","author":"Naji","year":"2023","journal-title":"Int J Epilepsy"},{"key":"ref7","first-page":"38","article-title":"D\u00e9ficit th\u00e9rapeutique de l\u2019\u00e9pilepsie au Maroc","volume":"38","author":"Serragui","year":"2019","journal-title":"Afr J Neurol Sci"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1007\/s40263-021-00827-8","article-title":"The pharmacology and clinical efficacy of antiseizure medications: from bromide salts to cenobamate and beyond","volume":"35","author":"Loscher","year":"2021","journal-title":"CNS Drugs"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1016\/j.seizure.2010.10.027","article-title":"Antiepileptic drug therapy the story so far","volume":"19","author":"Brodie","year":"2010","journal-title":"Seizure"},{"key":"ref10","first-page":"35","article-title":"Pharmacologie des anti\u00e9pileptiques: d'une g\u00e9n\u00e9ration \u00e0 l'autre","author":"Bordet","year":"2002","journal-title":"La Lettre du pharmacologue"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e191","DOI":"10.1111\/epi.13210","article-title":"Availability of antiepileptic drugs across Europe","volume":"56","author":"Baftiu","year":"2015","journal-title":"Epilepsia"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"674","DOI":"10.4103\/aian.AIAN_264_19","article-title":"Antiepileptic drug prices, availability and affordability in a resource-limited setting","volume":"23","author":"Singhi","year":"2020","journal-title":"Ann Indian Acad Neurol"},{"key":"ref13","first-page":"5","article-title":"L\u2019\u00e9pilepsie au Maroc, r\u00e9alit\u00e9s et perspectives","volume":"1","author":"Kissani","year":"2012","journal-title":"Afr Middle East Epilepsy J"},{"key":"ref14","first-page":"1","article-title":"Situation de l\u2019\u00e9pilepsie dans la r\u00e9gion Nord Afrique et Moyen orient et Printemps Arabe","author":"Kissani","year":"2012","journal-title":"Afr Middle East Epilepsy J"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"120119","DOI":"10.1016\/j.jns.2021.120119","article-title":"Why does Africa have the lowest number of neurologists and how to cover the gap?","volume":"434","author":"Kissani","year":"2022","journal-title":"J Neurol Sci"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"A63","DOI":"10.1016\/j.neurol.2013.01.144","article-title":"L\u2019\u00e9pilepsie dans la r\u00e9gion de F\u00e8s-Boulmane, Suivi prospectif d\u2019une cohorte de 60 patients","volume":"169","author":"Belfkih","year":"2012","journal-title":"Afr Middle East Epilepsy J"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1668","DOI":"10.1111\/epi.16610","article-title":"A pragmatic algorithm to select appropriate antiseizure medications in patients with epilepsy","volume":"61","author":"Asadi-Pooya","year":"2020","journal-title":"Epilepsia"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.seizure.2019.11.003","article-title":"Influence of new versus traditional antiepileptic drugs on course and outcome of status epilepticus","volume":"74","author":"Reindl","year":"2020","journal-title":"Seizure"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1016\/S0140-6736(20)30611-5","article-title":"Efficacy of levetiracetam, fosphenytoin, and valproate for established status epilepticus by age group (ESETT): a double-blind, responsive-adaptive, randomised controlled trial","volume":"395","author":"Chamberlain","year":"2020","journal-title":"Lancet"},{"key":"ref20","first-page":"S330","article-title":"Antiepileptic drugs: a consideration of clinical and biochemical outcome in patients with epilepsy","volume":"4","author":"Tolou-Ghamaro","year":"2013","journal-title":"Int J Prev Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"649589","DOI":"10.3389\/fneur.2021.649589","article-title":"Anti-seizure medication prescription in adult outpatients with epilepsy in China, 2013\u20132018","volume":"12","author":"Yu","year":"2021","journal-title":"Front Neurol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.nrl.2018.01.011","article-title":"Observational multicentre study into the use of antiepileptic drugs in Spanish neurology consultations","volume":"35","author":"Mercad\u00e9 Cerd\u00e1","year":"2020","journal-title":"Neurologia"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"179","DOI":"10.3988\/jcn.2022.18.2.179","article-title":"Trends in prescribing of antiseizure medications in South Korea: real-world evidence for treated patients with epilepsy","volume":"18","author":"Kang","year":"2022","journal-title":"J Clin Neurol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"108841","DOI":"10.1016\/j.yebeh.2022.108841","article-title":"Prescription trends in anti-seizure medications for adult patients with epilepsy in Japan: a retrospective cohort study using the database of health insurance claims between 2015 and 2019","volume":"134","author":"Jin","year":"2022","journal-title":"Epilepsy Behav"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1590\/0004-282X-anp-2020-0012","article-title":"Trends in prescribing patterns of antiepileptic drugs among older adult inpatients in a Brazilian tertiary center","volume":"79","author":"ASSIS","year":"2021","journal-title":"Arq Neuropsiquiatr"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e032551","DOI":"10.1136\/bmjopen-2019-032551","article-title":"Trends in antiepileptic drug treatment and effectiveness in clinical practice in England from 2003 to 2016: a retrospective cohort study using electronic medical records","volume":"9","author":"Powell","year":"2019","journal-title":"BMJ Open"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.seizure.2021.10.020","article-title":"Analysis of trends and factors determining initial antiseizure medication choice for epilepsy in Taiwan","volume":"93","author":"Chiang","year":"2021","journal-title":"Seizure"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1111\/epi.12392","article-title":"Clinical features, proximate causes, and consequences of active convulsive epilepsy in Africa","volume":"55","author":"Kariuki","year":"2014","journal-title":"Epilepsia"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"926","DOI":"10.2174\/1570159X17666181227165722","article-title":"Valproic acid and epilepsy: from molecular mechanisms to clinical evidences","volume":"17","author":"Romoli","year":"2019","journal-title":"Curr Neuropharmacol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e167","DOI":"10.1212\/WNL.0000000000007696","article-title":"Risks of 23 specific malformations associated with prenatal exposure to 10 antiepileptic drugs","volume":"93","author":"Bloti\u00e8re","year":"2019","journal-title":"Neurology"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"612","DOI":"10.12688\/f1000research.24748.1","article-title":"Recent advances in managing and understanding Stevens-Johnson syndrome and toxic epidermal necrolysis","volume":"9","author":"Hasegawa","year":"2020","journal-title":"F1000Res"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"826","DOI":"10.3390\/ph14080826","article-title":"Levetiracetam therapeutic drug monitoring in a large cohort of Korean epileptic patients","volume":"14","author":"Ha","year":"2021","journal-title":"Pharmaceuticals"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2147\/NDT.S181886","article-title":"Levetiracetam for epilepsy: an evidence map of efficacy, safety and economic profiles","volume":"15","author":"Yi","year":"2018","journal-title":"Neuropsychiatr Dis Treat"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"475","DOI":"10.3390\/ph15040475","article-title":"Levetiracetam mechanisms of action: from molecules to systems","volume":"15","author":"Contreras-Garc\u00eda","year":"2022","journal-title":"Pharmaceuticals"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1016\/S0140-6736(21)00247-6","article-title":"The SANAD II study of the effectiveness and cost-effectiveness of levetiracetam, zonisamide, or lamotrigine for newly diagnosed focal epilepsy: an open-label, non-inferiority, multicentre, phase 4, randomised controlled trial","volume":"397","author":"Marson","year":"2021","journal-title":"Lancet"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1016\/S0140-6736(07)60460-7","article-title":"The SANAD study of effectiveness of carbamazepine, gabapentin, lamotrigine, oxcarbazepine, or topiramate for treatment of partial epilepsy: an unblindedrandomised controlled trial","volume":"369","author":"Marson","year":"2007","journal-title":"Lancet"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"CD011412","DOI":"10.1002\/14651858.CD011412.pub4","article-title":"Antiepileptic drug monotherapy for epilepsy: a network meta-analysis of individual participant data","volume":"2022","author":"Nevitt","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1046\/j.1528-1157.2001.32800.x","article-title":"The treatment gap in epilepsy: the current situation and ways forward","volume":"42","author":"Meinardi","year":"2001","journal-title":"Epilepsia"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1111\/epi.12028","article-title":"Ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy: initial monotherapy outcomes at 12 months","volume":"54","author":"Glauser","year":"2013","journal-title":"Epilepsia"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2024.1435075\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T14:44:59Z","timestamp":1724424299000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2024.1435075\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,23]]},"references-count":39,"alternative-id":["10.3389\/fneur.2024.1435075"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2024.1435075","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,23]]},"article-number":"1435075"}}