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Study: epilepsy medication common in nursing homes

7 May, 2003

More than 10 per cent of residents in US nursing homes are taking anti-epileptic drugs, though only 5 or 6 per cent of residents have epilepsy.

A new study by the University of Minnesota looked at over 10,000 residents of 500 nursing homes across the country. They found that most of these patients were already on anti-epileptic drugs (AEDs) at admission, though a significant number were prescribed the drugs in the first three months after they entered a nursing home.

According to the authors, writing in the online edition of the Annals of Neurology, it is not surprising that many elderly are taking anti-epileptic medications. Lead author Professor Judith Garrard, from the University of Minnesota School of Public Health in Minneapolis, said:

"Contrary to the popular belief that the occurrence of epilepsy is greatest among newborns and infants, the onset of this condition is actually highest among people over the age of 65. What has not been fully realized until recently is the extent to which these drugs are being used by elderly nursing home residents."

AEDs are also prescribed for conditions such as bipolar depression, pain generated in nerve fibers, and some behavioural problems associated with dementia. However, Professor Garrard added that the use of AEDs is complicated and often calls for the input of a specialist who can determine which drug should be used. It is also important to note that some AEDs can have side-effects such as poor coordination, confusion, or sedation, and some may interact adversely with other types of medication.

It has been noted in previous research that AED use is much higher among nursing home residents than among elderly in the general population. As part of a grant from the National Institutes of Health to study AED use in the elderly, Garrard and her colleagues sought to find out whether the majority of nursing home patients taking AEDs were already on the medications before entering the home, or whether they were later prescribed the drugs.

“This is surprising since many primary care providers assume that few, if any, medications are initiated after an elderly person enters a nursing home," said Garrard.

Of the patients already taking AEDs before admission, 60 per cent were taking the drugs for seizures. Conversely, only 20 per cent of those placed on AEDs after admission received the drugs to prevent seizures.