Mental health

When to discontinue antiepileptic drug treatment in adults and children

Question 9: In adults and children with convulsive epilepsy in remission, when should treatment be discontinued?

Management of epilepsy

  • Population: children or adults with epilepsy in remission
  • Interventions: early discontinuation (less than 2 year seizure-free period)
  • Comparison: late discontinuation (more than 2 year seizure-free period)
  • Outcomes:
    • seizure relapse rate
    • mortality
    • adverse effect of antiepileptic drugs
    • quality of life
    • stigma
    • risk of intractable epilepsy after antiepileptic drug withdrawal.

Recommendation(s)

In children and adults with epilepsy, discontinuation of antiepileptic drug treatment should be considered after two seizure-free years. After a two year seizure-free period, the decision to withdraw or continue antiepileptic drugs in a seizure-free patient, should be made after consideration of relevant clinical, social and personal factors and with the involvement the patient and the family.
Strength of recommendation: STANDARD

Evidence profile

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