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Changing trends in antiepileptic drug prescribing in girls of child-bearing potential
  1. Ruth Ackers (ruth.ackers{at}
  1. The School of Pharmacy, University of London, United Kingdom
    1. Frank M C Besag (fbesag{at}
    1. Twinwoods Health Resource Centre, Bedfordshire and Luton Partnership NHS Trust, United Kingdom
      1. Angie Wade (a.wade{at}
      1. Institute of Child Health, University College London, United Kingdom
        1. Macey L Murray (macey.murray{at}
        1. The School of Pharmacy, University of London, United Kingdom
          1. Ian C K Wong (ian.wong{at}
          1. The School of Pharmacy, University of London, United Kingdom


            Objective: To characterize prescribing trends of the most commonly prescribed antiepileptic drugs (AEDs) in adolescent females in the UK, carbamazepine (CBZ), sodium valproate (VPA) and lamotrigine (LTG) and to examine possible reasons for the changing trends.

            Design: Population-based observational study.

            Setting: UK General Practice Research Database between 1 January 1993 and 31 December 2006.

            Patients: Subjects aged 12-18 years who were issued ≥1 CBZ, VPA or LTG prescription.

            Main outcome measures: Prescribing prevalences stratified by age, gender and antiepileptic drug.

            Results: 5417 patients (47.6% females) were prescribed 147,111 prescriptions for CBZ (34.5%), VPA (38.6%) or LTG (26.9%). The prevalence of LTG prescribing in females increased from 0.08 (95% CI 0.04, 0.12) to 0.80 (95% CI 0.70, 0.89) per 1000 female population. Conversely the prevalence in females of CBZ and VPA significantly decreased from 1.00 (95% CI 0.85, 1.15) to 0.51 (95% CI 0.44, 0.58) and 0.94 (95% CI 0.80, 1.09) to 0.63 (95% CI 0.55, 0.72) respectively. This 10-fold rise in LTG prescribing in females is much higher than the 5-fold rise in males; from 0.09 (95% CI 0.05, 0.14) to 0.47 (95% CI 0.40, 0.54) per 1000 male population.

            Conclusion: Prescribing practice of AEDs in adolescents has changed gradually over the last decade. More females aged 12-18 years are prescribed LTG compared to CBZ or VPA and the increase is much greater than for males. The increase in LTG prescribing is mirrored by a corresponding decrease in both VPA and CBZ. We believe concerns about potential problems to the offspring appear to be affecting prescription trends in adolescent females of child-bearing potential.

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