Neuroscience Institute Medical Director David Vossler, MD, FAAN has been busy advancing his field with the recent publication of two scholarly works. In the book “Controversies in Caring for Women with Epilepsy,” Dr. Vossler co-authored Chapter 15 about taking the anticonvulsant drug Lamotrigine during pregnancy. The book is available from Springer.
Dr. Vossler’s second published piece is the American Epilepsy Society’s “Position Statement on Generic Substitution of Antiepileptic Drugs,” an important subject for medical cost containment.
What’s the AES and Dr. Vossler’s bottom line? “Patients and providers can now have reasonable confidence of BE (BioEquivalence) when switching from brand-name to generic, or between generic, immediate-release AEDs (antiepileptic drugs). When presenting this to patients, providers will likely encounter questions or concerns. Patients are usually skeptical if they previously experienced increased seizures or other adverse effects when they switched from brand-name to generic AEDs. It may be helpful to counsel them about the possible reasons for this. One explanation is that after switching to a generic AED, patients who experience increased seizure frequency, duration, or severity may attribute this to the switch even though it could be due to the natural variation of seizures. Other reasons, such as emotional stress due to switching or decreased adherence due to differences in pill appearance, could result in seizures or adverse effects. With many patients, HCPs may find it helpful to spend extra time discussing these alternative explanations for past negative experiences and how the present studies provide reassurance about the safety of switching from brand-name to generic, and between generic formulations of, immediate release AEDs.”
