Abstract Details

Title Age, Gender, and Menopause Related Trends in Anti-seizure Medication Usage

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P4 - Poster Session 4 (8:00 AM-9:00 AM)

Poster/Presentation
Number 10-007

Objective To evaluate anti-seizure medication (ASM) usage patterns in patients with epilepsy, comparing men and women over age 55, and assessing differences in ASM utilization in women before and after menopause.

Background Postmenopausal women experience hormonal changes that affect seizure thresholds, drug metabolism, and sensitivity, often requiring adjustments in ASM type or dosage, Additionally, studies show the increasing incidence of epilepsy in older age groups, either in the setting of neurodegenerative, structural or metabolic disorders. This population presents unique challenges that influence ASM selection and tolerability. While treatment guidelines exist for women of reproductive age, there is a dearth of studies focused on postmenopausal women.

Design/Methods We conducted a retrospective analysis using Epic’s (Electronic Medical Record) data exploration tool, Slicer Dicer. Age 55 was selected as an approximate threshold for menopause. Patients prescribed at least one of 12 commonly used ASMs were included. We compared ASM usage between men and women over 55, and between women under vs above age 55. Differences were assessed using chi-square tests.

Results Our analysis included 5,844 women <55 (W<55), 4,266 women >55 (W>55) and 3,854 men above 55 (M>55). ASM distribution was similar between M>55 and W>55. In contrast, marked differences were observed between W<55 vs W>55 respectively: (1) ASMs more prevalent in W<55: Lamotrigine (27.89% vs 16.99%, p<0.001), Clobazam (10.06% vs 2.93%, p<0.001), Oxcarbazepine (6.10% vs 3.16%, p<0.001). (2) ASMs more prevalent in W>55: Levetiracetam (36.24% vs 43.48%, p<0.001) Gabapentin (7.54% vs 13.64%, p<0.001), Carbamazepine (2.53% vs 5.43%, p<0.001).

Conclusions Distinct differences in ASM prescribing patterns exist between pre- and postmenopausal women with epilepsy. We aim to expand the current study to the ECAM Consortium centers to validate these patterns across broader population. Future studies examining the drivers and clinical consequences of these differences will inform more tailored prescribing practices for women with epilepsy across the reproductive lifespan.

Authors/Disclosures
Sindhu R. Rao, MBBS (Baylor College of Medicine) PRESENTER	Dr. Rao has nothing to disclose.
Rani A. Sarkis, MD, MSc (Brigham and Women'S)	The institution of Dr. Sarkis has received research support from NINDS.
Paula E. Voinescu, MD (Brigham and Women'S Hospital)	The institution of Dr. Voinescu has received research support from Epilepsy Foundation of New England. The institution of Dr. Voinescu has received research support from BWH - Connors Center. The institution of an immediate family member of Dr. Voinescu has received research support from American Epilepsy Society. Dr. Voinescu has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Phillipines League Against Epilepsy. Dr. Voinescu has received personal compensation in the range of $500-$4,999 for serving as a PhD Opponent with University of Bergen, Norway. Dr. Voinescu has a non-compensated relationship as a Board Member and Chair with My Epilepsy Story that is relevant to AAN interests or activities. Dr. Voinescu has a non-compensated relationship as a Speaker with Epilepsy Foundation that is relevant to AAN interests or activities. Dr. Voinescu has a non-compensated relationship as a Grant Reviewer with American Epilepsy Society that is relevant to AAN interests or activities. Dr. Voinescu has a non-compensated relationship as a Member of Scientific Advisory Committee with North American AED Pregnancy Registry that is relevant to AAN interests or activities.

��ɫ��

��ɫ��