Concomitant therapy in people with epilepsy: Potential drug-drug interactions and patient awareness

Sara Eyal*, Sivan Rasaby, Dana Ekstein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


People with epilepsy (PWE) may use prescription and over-the-counter (OTC) drugs for the treatment of concomitant diseases. Combinations of these drugs, as well as dietary supplements, with antiepileptic drugs (AEDs) may lead to reduced control of seizures and of coexisting medical conditions and increased risk of adverse drug reactions (ADRs). The aims of this study were to obtain comprehensive lists of medications, dietary supplements, botanicals, and specific food components used by adult PWE and to evaluate the potential for interactions involving AEDs and patients' awareness of such potential interactions. We conducted a prospective, questionnaire-based study of PWE attending the Hadassah-Hebrew University Epilepsy Clinic over a period of 7. months. The questionnaire interview included the listing of medications, medicinal herbs, dietary supplements, and specific food components consumed and the knowledge of potential drug-drug interactions (DDIs), and it was conducted by a pharmacist. Drug-drug interactions were analyzed via the Micromedex online database. Out of 179 patients who attended the clinic over the study period, we interviewed 73 PWE, of which 71 were included in our final analysis. The mean number of AEDs consumed per subject was 1.7 (SD: 0.8, range: 1-4). Forty (56%) subjects were also treated with other prescription and/or OTC medications, and thirty-four (48%) took dietary supplements. Drug families most prone to DDIs involving AEDs included antipsychotic agents, selective serotonin reuptake inhibitors, and statins. Two-thirds of study participants (67%) knew that DDIs may lead to ADRs, but only half (56%) were aware of the potential for reduced seizure control. Only 44% always reported treatment with AEDs to medical professionals. This study provides for the first time a comprehensive picture of prescription and OTC drugs and food supplements used by PWE. Despite a considerable potential for DDIs involving AEDs, patient awareness is limited, highlighting the importance of patient and caregiver education.

Original languageAmerican English
Pages (from-to)369-376
Number of pages8
JournalEpilepsy and Behavior
StatePublished - Feb 2014

Bibliographical note

Funding Information:
None of the authors has any conflict of interest to disclose. Sivan Rasaby was supported by the Hebrew University School of Pharmacy. The funding source was not involved in study design; data collection, analysis, and interpretation; writing the report; and decision to submit the article for publication.


  • Antiepileptic drugs
  • Dietary supplements
  • Interactions
  • Patient awareness


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