Sep 12, 2023

Older patients more likely to be prescribed outdated antiseizure medications

Stroke is a major cause of disability and death worldwide but there is no robust data on the optimal management of poststroke seizures and epilepsy. [Source: Shutterstock]

Key points:

  • Compared to the general population, people who experience a stroke are at higher risk of developing epilepsy
  • An ischemic stroke occurs when a vessel supplying blood to the brain is obstructed
  • Experts say older antiseizure medications can lead to side-effects and interactions, which may be harmful to those who are vulnerable to health-related issues

In the event of an ischemic stroke, older patients have been found to be prescribed older antiseizure medications, leaving them open to adverse reactions. 

A new study from Monash University has found the vulnerable group – including those with dementia, psychiatric conditions and patients aged 85 years and older – are more likely than other patient groups to be dispensed older antiseizure medications following ischaemic stroke.

Antiseizure medications are the main treatment option for controlling seizures after stroke and while there was an overall trend toward the dispensing of newer antiseizure medications over time, it was older people being prescribed older medications. People living in rural areas were less likely to receive the newer medication compared to metropolitan areas.

The team of researchers from the Centre for Medicine Use and Safety (CMUS) at the Monash Institute of Pharmaceutical Sciences followed 19,601 people hospitalised with a first ischaemic stroke in Victoria from 2013-2017. Of these people, 989 were dispensed antiseizure medication within 12 months of hospital discharge.

Compared to the general population, people who experience a stroke are at higher risk of developing epilepsy, which is a common and serious neurological disorder characterised by recurrent unprovoked seizures.

“Our hope is the findings from this study will pave the way for further investigation into the effectiveness and safety of different antiseizure medications in Australia’s most vulnerable groups.”

CMUS PhD candidate Stella Kim said those aged 60 years and older run a higher risk of developing newly diagnosed epilepsy after stroke, and therefore optimal medication treatment plans are crucial.

“Antiseizure medications are the main treatment option for controlling seizures after stroke, and treatment should be individualised according to factors such as seizure type, demographic factors, comorbidities and concurrent medications,” she said.

“Our study highlights the need for further research into the comparative safety and effectiveness of antiseizure medications.”

Similar studies conducted in Sweden and the United States found that patients were more likely to be prescribed newer medications from neurologists compared to other specialists like General Practitioners (GPs). The uneven distribution of neurologists between metropolitan and regional Victoria could have accounted for different treatment preferences and since there are no Australian clinical practice guidelines on poststroke seizures, physicians may prefer to choose medications with a longer history of proven benefits.

The findings have been published in Epilepsia Open and were presented at the International Conference on Pharmacoepidemiology & Therapeutic Risk Management in Halifax Canada.

Leave a Reply

Your email address will not be published. Required fields are marked *


BUPA – Not Good Enough To Care For Fit Soldiers, But Good Enough To Care For The Elderly?

Reputation means everything when it comes to business, and it’s fair to say that the reputation of Bupa as a brand has taken a number of hits over the last 18 months. The Australian aged care sector is currently under the spotlight for all the wrong reasons, and with nine homes currently sanctioned, Bupa has... Read More

Aged care residents experience the value of play through theatre classes

Playing up happens every Saturday morning for residents at Uniting’s The Marion aged care facility in Leichhardt, Sydney. Read More

Should Night-Shift Staff Be Showering Aged Care Residents?

When a person enters the latter stages of their life, variety and personal choice can be forced to make way for necessity due to diminished cognitive and physical abilities. Upon entering aged care, many residents find themselves at a point where they require assistance for the most basic of tasks, which is why opportunities that... Read More