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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]