When to discontinue antiepileptic drug treatment in adults and children
Question 9: In adults and children with convulsive epilepsy in remission, when should treatment be discontinued?
- Population: children or adults with epilepsy in remission
- Interventions: early discontinuation (less than 2 year seizure-free period)
- Comparison: late discontinuation (more than 2 year seizure-free period)
- Outcomes:
- seizure relapse rate
- mortality
- adverse effect of antiepileptic drugs
- quality of life
- stigma
- risk of intractable epilepsy after antiepileptic drug withdrawal.
Recommendation(s)
In children and adults with epilepsy, discontinuation of antiepileptic drug treatment should be considered after two seizure-free years. After a two year seizure-free period, the decision to withdraw or continue antiepileptic drugs in a seizure-free patient, should be made after consideration of relevant clinical, social and personal factors and with the involvement the patient and the family.
Strength of recommendation: STANDARD