Title
Antiseizure Medication Withdrawal in Seizure-Free Patients
Authoring Organization
Publication Month/Year
December 5, 2021
Last Updated Month/Year
October 11, 2024
Supplemental Implementation Tools
Document Type
Guideline
Country of Publication
US
Document Objectives
To update a 1996 American Academy of Neurology practice parameter.
PICO Questions
For patients with epilepsy taking antiseizure medications (ASMs) who have been seizure-free for at least 12 months, does stopping ASMs compared with not stopping increase the risk of seizure recurrence, and are there risk factors for seizure recurrence?
For patients with epilepsy who take antiseizure medications (ASMs) and have been seizure-free for at least 12 months, does stopping ASMs, compared with not stopping, increase the risk of status epilepticus?
For patients with epilepsy taking antiseizure medications (ASMs) who have been seizure-free for at least 12 months, does stopping ASMs, compared to not stopping, reduce medication-related side effects?
For patients with epilepsy taking antiseizure medications (ASMs) who have been seizure-free for at least 12 months, does stopping ASMs, compared to not stopping, change quality of life?
For patients with epilepsy taking antiseizure medications (ASMs) who have been seizure-free for at least 12 months, does stopping ASMs, compared to not stopping, change the risk of mortality?
For patients with epilepsy taking antiseizure medications (ASMs) who have been seizure-free for at least 12 months, does stopping ASMs, compared with not stopping, change the risk of seizure recurrence based on the speed of medication withdrawal?
Inclusion Criteria
Male, Female, Adolescent, Adult, Child, Older adult
Health Care Settings
Ambulatory
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Treatment, Management
Diseases/Conditions (MeSH)
D004827 - Epilepsy, D012640 - Seizures, D013375 - Substance Withdrawal Syndrome
Keywords
seizure, epilepsy, seizures, antiseizure, withdrawal
Source Citation
Gloss D, Pargeon K, Pack A, Varma J, French JA, Tolchin B, Dlugos DJ, Mikati MA, Harden C; AAN Guideline Subcommittee. Antiseizure Medication Withdrawal in Seizure-Free Patients: Practice Advisory Update Summary: Report of the AAN Guideline Subcommittee. Neurology. 2021 Dec 7;97(23):1072-1081. doi: 10.1212/WNL.0000000000012944. PMID: 34873018.