Monotherapy and polytherapy in Paediatric seizures: A prospective, observational study in a tertiary care teaching hospital

Background: Epilepsy is a common neurological disorder in children and its treatment still remains a challenge for the physicians. Though there are a number of anti-epileptic drugs with varying mechanisms of action, their adverse effects, and drug interactions are to be analyzed before starting a therapy. Aim: To study the pattern of prescription in the treatment of pediatric seizures. Objectives: To observe the pharmaco-epidemiology, utilization pattern and effectiveness of monotherapy and polytherapy in the treatment of seizures in children aged above 2 years. Materials and methods: This prospective, longitudinal study was conducted for a period of 8months in Paediatric Neurology Department of a tertiary care teaching hospital. The data collected from 41 children at the end of the study, were compiled in a specially designed data form and were analyzed. Results: The distribution of Paediatric seizures was found to be high in male children (62%) and in the age group of 2 to 5 years (46%). GTCS (85%) was the dominant type of seizure seen in children and 83% of the children were treated with monotherapy. Polytherapy was found to be efficacious compared to monotherapy, with a good seizure control (100%: 94%), good compliance and minimal adverse effects (14.2%: 14.7%). Conclusion: Monotherapy still remains the mainstay of treatment in pediatric seizures. Though polytherapy appears to be a better option in this study, epilepsy in children requires a long term treatment and hence adverse effects in long term and the effects of drug interactions are the main criteria to be taken care of. A study of longer duration in the treatment of pediatric seizures will provide a better knowledge in the adverse effects of polytherapy.