Trendy w populacji dotyczące współzażywania leków psychiatrycznych u osób z epilepsją: badanie EPIC Cosmos
Population-level trends of Psychiatric Medication Co-Prescriptions in Persons with Epilepsy: an EPIC Cosmos Study
W skrócie
[Preprint - wstępne wyniki] Badanie wykazało, że osoby z epilepsją otrzymują znacznie więcej leków na depresję, psychozę i opioidy niż pacjenci z astmą. Dzieci i młodzież z epilepsją częściej otrzymują leki na ADHD, podczas gdy dorośli bardziej sięgają po leki wspomagające pamięć. Naukowcy nie znaleźli, by jakikolwiek lek przeciwpadaczkowy był szczególnie często łączony z lekami psychiatrycznymi.
Oryginalny abstract (angielski)
Persons with epilepsy (PWE) experience high rates of psychiatric comorbidity, yet the population-scale pharmacoepidemiology of psychiatric medication (PM) use alongside antiseizure medications (ASMs) has not been previously characterized. Using Epic Cosmos, a federated electronic health record network spanning >300 million patients across >2,000 hospital systems, we examined patterns of ASM and PM co-prescriptions in PWE (ICD- 10 G40.x) every year between 2018-2025. PM prescriptions were similarly assessed in patients with asthma (J45.x). We found that despite the introduction of several newer ASMs, the overall prescribing landscape remained stable, with little change in the relative use of individual ASMs over time. Compared with asthma patients, PWE were more likely to receive prescriptions for opiates, antidepressant and antipsychotic medications across the age spectrum. 17-year-old or younger PWE were more likely to receive ADHD/stimulant medications, whereas adults and older adults exhibited a shift toward cognitive enhancing agents. We did not observe a preponderance of PM co- prescribing with any specific ASM or ASM class. Together, these results provide a population-scale, age-specific survey of psychiatric medication co-prescriptions in epilepsy, establishing a framework to monitor surrogate markers of psychiatric comorbidity and to support pharmacovigilance of potential drug-drug interactions.