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Epilepsy drugs rise

GP prescribing of new anti-epileptic drugs to children is rising sharply despite concerns over their cost-effectiveness.

A UK study revealing a 3.5-fold increase in use of the newer drugs which include lamotrigine, gabapentin and levetiracetam was presented this week against the backdrop of an NHS review questioning the evidence for their use.

The study of records from the UK general practice research database found that between 1992 and 2004, prevalence of use of the drugs in children increased from 0.9 to 3.2 per 1,000 patient-years.

Study leader Ruth Ackers, a research pharmacist at the Centre for Paediatric Pharmacy Research at the University of London, said: 'Further work is needed to ascertain the incidence of prescribing.

'Duration of treatment and what conditions the drugs are being prescribed for ­ but above all the safety of these newer drugs ­ needs to be determined.'

Meanwhile a Health Technology Assessment, to be submitted to NICE, failed to find evidence that the newer drugs were 'clearly cost-effective', although neither was there evidence they were clearly not cost-effective.

It concluded: 'There is no clinical evidence to suggest the

newer agents should be considered as a first-choice treatment in any form of epilepsy in


But Dr Greg Rogers, a GPSI in epilepsy for east Kent and a member of the executive committee of the Primary Care Neurology Society, said: 'New anti-convulsant medications have invariably got a superior side-

effect profile to the older medications, in particular with the lack of drowsiness and the reduction of interactions with other medications.

'Quality of life is important for children as it is for adults.'

The research on prescribing is to be presented at the Royal College of Paediatrics and Child Health conference in York early next month.

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