ASM titration is an understudied component of FS management. Few studies have characterized real-world titration experiences from both patient and HCP perspectives.

An IRB-approved web survey of patients with FS (N = 48; January 2025) evaluated patient titration experiences. Seven US HCPs (epileptologists with a mean 20 years in practice) completed 30-minute interviews about ASM titration and subsequently participated in a roundtable discussion (April 2025).

Patients self-reported barriers during titration, including difficulty following schedules due to frequent dose changes (42%) and disruptions to daily life from clinic visits and phone calls (42%). All HCPs (100%) identified drug–drug interactions (DDIs) as a titration challenge and reported difficulty managing cross-titration when switching ASMs to mitigate interaction risks.

Among patients, 85% reported feeling nervous during titration at least “some of the time,” whereas fewer than 15% of patients reported feeling “calm and peaceful” or “happy” “most or all of the time” during titration. All HCPs (100%) indicated that the titration process can be associated with stress for patients, providers, or both.

When considering an ASM without titration, 84% of patients agreed it would be easier to remember how to take the medication properly, and 77% agreed they would feel less anxious. The majority of HCPs (86%) agreed that minimal- or no-titration ASMs can lessen the burden for patients and providers.