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Summary: Purpose: The aim of this study was to evaluate the prevalence of prescription and use of antiepileptic drugs (AEDs) for the treatment of epilepsy and other indications in a nationwide population using a prescription database. Materials and methods: AED prescription data were collected from the National Health Insurance Research Database (NHIRD) in Taiwan for a 5-year period (2003–2007). Patients prescribed AEDs at least two times from 2003 to 2007 were selected for the study from a random sample that included approximately 600,000 people. Results: The prevalence of AED use (per 1000 inhabitants) increased from 12.6 in 2003 to 13.8 in 2007. The prevalence of newer AED use increased progressively from 1.0 in 2003 to 3.8 in 2007, but the prevalence of older AED use decreased during this time (11.6–10). Carbamazepine and valproic acid were the most common AEDs used. Among the newer generation of AEDs, gabapentin was the most frequently used. Newer AEDs were used primarily to treat pain disorders. The primary class of drugs used to treat epileptic disorders was older AEDs. Conclusion: An increase in the use of AEDs was observed over a 5-year period in data collected from NHIRD. This might implicate the use of newer compounds at clinical practice not only increased in the treatment of epilepsy, but also in the conditions other than epilepsy especially pain disorders. [Copyright &y& Elsevier]

Summary: Objective: The objective of this study was to analyze and evaluate antiepileptic drug (AED) utilization among adults in Taiwan. Methods: A random sample of 167,377 patients from the National Health Insurance (NHI) reference database was used. Prescription records were retrieved for all patients prescribed AEDs during 2004. The prescribed daily dose/defined daily dose (PDD/DDD) ratio was used to assess the adequacy of AED dosing. Results: Seventy-one percent (n =518) of patients used only one AED, while 29% (n =212) used more than two AEDs in 2004. For monotherapy, the most frequent regimens included carbamazepine (41.9%), followed by phenytoin (27.3%) and valproic acid (17.8%). For polytherapy, the most commonly used combination was valproic acid and carbamazepine. For adults, the mean PDD/DDD ratio for each AED used for either monotherapy or polytherapy was less than 1.00. Additionally, adult patients treated with more than one AED during 2004 in Taiwan took each drug in higher dose than patients using the same AED in monotherapy. Conclusion: In Taiwan antiepileptic drug therapies appear to be still dominated by the first generation drugs. The mean dosages of most antiepileptic drugs were lower than that of WHO suggested. [Copyright &y& Elsevier]

Summary: Objective: To determine the prevalence of treated epilepsy in the Taiwan in 2004 using prescription data from the National Health Insurance (NHI) research database and to compare this rate with estimates from other prevalence studies. Methods: A cohort was extracted from a group of antiepileptic drug (AED) users who met two inclusion criteria: (1) use of AED more than once and International Classification of Disease (ICD) codes indicating epilepsy or (2) use of AEDs except clonazepam for more than 90 days without ICD codes of epilepsy. Results: In total, 559 AED users were included. The estimated crude prevalence of AED use was 0.42% of the adult population (0.4% for women and 0.45% for men), and 72% of the cohort (n =400) used only one AED. Conclusion: Our estimate of prevalence of treated epilepsy through the NHI system has much larger coverage of population with more credible registration system, and appears to be closer to the truth than two previous small-scaled community-based studies in Taiwan. [Copyright &y& Elsevier]

• The predominant therapeutic approach was monotherapy, especially for elder adults. • Valproic acid was the most prescribed AED monotherapy in Taiwan. • The PDD/DDD ratio of each antiepileptic monotherapy was less than 1 in adult patients. To evaluate the prescription patterns and prescribed daily dose (PDD)/defined daily dose (DDD) ratios of antiepileptic drugs (AEDs) in prevalent patients with epilepsy in Taiwan. A nationwide retrospective cross-sectional study was conducted for prevalent patients with epilepsy in 2016 using the Taiwanese National Health Insurance Research Database. The prescription records of AEDs of all prevalent patients with epilepsy were retrieved. The mean PDDs and PDD/DDD ratios of AEDs in adult patients were obtained to evaluate dosing adequacy. A chi-square test and two-sample t test were used to analyze the differences in AED prescription patterns and dosages, respectively, among patients with different ages, sexes, comorbidities, and therapeutic approaches. A total of 118,937 prevalent patients with epilepsy were enrolled. The predominant therapeutic approach was monotherapy, especially in the elder adults, accounting for 82.9% of elder adult patients with epilepsy. The proportion of AED monotherapy was higher in patients with dementia (78.9%) and stroke (80.6%). The top three antiepileptic monotherapies were valproic acid (28.7%), levetiracetam (19.1%), and phenytoin (16.9%); however, oxcarbazepine (22.8%) was substituted for carbamazepine (3.9%) as monotherapy for patients aged 0–17 years. Among adult patients with epilepsy, the PDD/DDD ratio of each AED in monotherapy was less than 1.00. The mean PDD of each AED was higher in polytherapy than in monotherapy (p < 0.01), except for lacosamide. The mean PDDs of all evaluated AEDs in monotherapy were lower in elder adult patients than in younger adult patients, most of which reached statistical significance (p < 0.001). In Taiwan, valproic acid was the most prescribed AED for prevalent patients with epilepsy. The mean PDDs of most AEDs were lower than the DDDs developed by the World Health Organization. [ABSTRACT FROM AUTHOR]