Exploring the factors influencing the usage of antiepileptic drugs in women with epilepsy

Background: Levetiracetam's relatively low teratogenic risk and minimal interactions with hormonal contraceptives have made it a preferred option in the management of women with epilepsy (WWE). This study aimed to analyze and evaluate the factors influencing antiepileptic drug (AED) usage in WWE. Methods: The observational cross-sectional survey was conducted between April 2024 to May 2024, among neurologists from various regions across India, who are having special epilepsy clinics. Results: A total of 253 neurologists participated in the survey. Approximately 47.04% of the neurologists reported that 20-40% of their patients were female in their clinical practice, while 45.06% reported that 40-60% of their patients were female. The majority of neurologists prefer levetiracetam for treating WWE across various groups: 87.75% for reproductive-age women with focal epilepsy, 84.98% for generalized epilepsy, and 73.91% for pediatric patients. It is also widely prescribed for elderly women (70.36%), pregnant women (86.56%), and breastfeeding women (85.38%). Additionally, 74.31% neurologists recommend it for male partners with epilepsy due to its high efficacy and tolerability. About 47.04% of neurologists preferred levetiracetam for treating WWE due to its advantage in lowering the risk of teratogenicity, followed by 26.48% who cited better seizure control. To reduce the teratogenic risk, 34.94% of neurologists consider alternative medications with lower teratogenic potential, while 34.94% consider folic acid supplementation. Conclusion: The survey highlights a strong preference among neurologists for levetiracetam in treating WWE across various patient groups.