BMJ neurology open · 2026
A mixed-methods study of patient perspectives on antiseizure medication discontinuation attempts after a period of seizure-freedom.
СтатьяНазвание и аннотация: Перевод в очереди
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Terman Samuel W, Silva Jordan M, Kuster Max, Lee Jasper, Brand Amanda, Manuel Kara, Kalia Navya, Dugan Micaela, Reid Marla, Mortati Katherine, Tolmasov Alexandra, Burke James F, Hill Chloé E, Okula Susanna S, Patel Palak S
Аннотация
BACKGROUND: Antiseizure medications (ASMs) are the standard treatment for epilepsy. Yet because ASMs can have adverse effects and seizure risk decreases with longer seizure-free periods, guidelines have suggested considering ASM withdrawal after a period of seizure-freedom. However, work exploring patient experience with ASM discontinuation is scarce. We explored patient attitudes regarding past or possible future ASM discontinuation attempts.
METHODS: We conducted a mixed-methods study of adults at least 1 year seizure-free, seen for epilepsy across three institutions. A semistructured interview script assessed views about past or hypothetical future ASM discontinuation attempts.
RESULTS: We interviewed 32 participants. Seizure-free duration ranged from 1.0 to 35.0 years (median 2.9, IQR 1.6-11.2). 21 (66%) participants reported having tried to discontinue an ASM in the past due to a period of seizure-freedom. 13 participants (43% of 30 who responded to the question) felt that they would still be glad to have tried discontinuation for the knowledge gained even if it resulted in a seizure. This corresponded to 52% (11/21) of patients who had previously attempted ASM discontinuation due to a period of seizure-freedom, compared with 22% (2/9) of patients who had not previously attempted ASM discontinuation (Fisher's exact test p=0.23). Qualitative responses generally indicated that even a 'Ошибка' discontinuation attempt was 'worth trying' and could support a patient's future decision to remain on long-term ASMs without wondering any longer if they really 'need it.'
CONCLUSIONS: Even 'Ошибка' discontinuation attempts may have value due to knowledge gained to support subsequent continuation.
METHODS: We conducted a mixed-methods study of adults at least 1 year seizure-free, seen for epilepsy across three institutions. A semistructured interview script assessed views about past or hypothetical future ASM discontinuation attempts.
RESULTS: We interviewed 32 participants. Seizure-free duration ranged from 1.0 to 35.0 years (median 2.9, IQR 1.6-11.2). 21 (66%) participants reported having tried to discontinue an ASM in the past due to a period of seizure-freedom. 13 participants (43% of 30 who responded to the question) felt that they would still be glad to have tried discontinuation for the knowledge gained even if it resulted in a seizure. This corresponded to 52% (11/21) of patients who had previously attempted ASM discontinuation due to a period of seizure-freedom, compared with 22% (2/9) of patients who had not previously attempted ASM discontinuation (Fisher's exact test p=0.23). Qualitative responses generally indicated that even a 'Ошибка' discontinuation attempt was 'worth trying' and could support a patient's future decision to remain on long-term ASMs without wondering any longer if they really 'need it.'
CONCLUSIONS: Even 'Ошибка' discontinuation attempts may have value due to knowledge gained to support subsequent continuation.