A San Antonio-based study suggests a more effective outcome might be achieved for epilepsy patients through a change in prescription protocols.
The study showed that patients responded better to combinations of anti-epileptic drugs with different mechanisms than to combinations of drugs of that act in the same way.
Dr. Jose Cavazos, director of the MD/PhD program at the UT Health Science Center, said although newer epilepsy drugs have fewer side effects, there has been little data on combining drugs.
"The dogma has been that you use medications serially: First one medicine, the patients fails it, you go to the next medication, the patient fails it and you go to another medication. So that has been the serial monotherapy," Cavazos said.
More recently, Cavazos said combinations of drugs have been used, and he set out to discover the varying results.
He spent two years weeding through 96 million patient records from insurance databases, and found among 8,600 patients that combinations of drugs with different mechanisms resulted in better efficacy and fewer complications.
"We also found that -- and this is important to total health care costs -- that they were going less to the emergency room, that they were having less hospitalizations for procedures as well as for other complications, and they were refilling medications for a much longer period of time," Cavazos said.
Cavazos said even though the drugs may cost more initially, the reduced hospital care and complications resulted in a lower overall health care cost.
The study is published in JAMA Neurology online.
