Extended-release Antiepilepsy Drugs—Review of the Effects of Once-daily Dosing on Tolerability, Effectiveness, Adherence, Quality of Life, and Patient Preference

Abstract

Long-term adherence to antiepilepsy drug (AED) regimens is frequently suboptimal. Poor adherence to therapy is associated with a number of negative consequences, including an increase in patient seizures and mortality. Nonadherence is related to a variety of factors, such as treatment-related adverse events, convenience of treatment, efficacy, and quality of life. There is therefore a need for treatment strategies in epilepsy that improve long-term adherence. One such strategy is the use of extended-release (ER) AED formulations. Advantages of ER AEDs over other AED formulations include the potential for once-daily dosing, a more stable mean drug concentration over time, improved tolerability profiles, maximal use of the therapeutic window, and the possibility to achieve better seizure control. Improvements in overall treatment effectiveness may therefore increase patient adherence. This review presents evidence related to patient adherence and preference patterns for ER AEDs and highlights the beneficial properties of ER AEDs.