Study Finds Most Epilepsy Patients Wait About a Year for Seizure Control After Treatment Initiation

A recent study published in JAMA Neurology highlights that individuals diagnosed with focal epilepsy often endure an extended period before achieving seizure relief through medication. While antiseizure drugs are effective for the majority, most patients continue to experience seizures for at least a year after starting treatment. This delay is primarily due to the time needed for physicians to identify the most suitable medication and dosage for each person.

Focal epilepsy, accounting for approximately 60% of all epilepsy cases, involves nerve cells in specific brain regions emitting excessive electrical signals, leading to seizures that can affect emotions, perceptions, and behaviors. The study, conducted by researchers at NYU Langone Health and part of the international Human Epilepsy Project, examined nearly 450 newly diagnosed patients, including adults and teenagers.

Findings revealed that over half of the participants did eventually find an effective medication, but it typically took around 12 months before significant seizure reduction was observed. Many individuals required even longer to reach a seizure-free state. Notably, about 63% experienced persistent or worsening seizures during the first year of therapy, regardless of whether they ultimately achieved control.

Data indicated that patients with less frequent seizures prior to treatment responded more quickly, whereas those with a history of psychological disorders like anxiety or depression were more prone to medication resistance. The study also sheds light on current prescribing habits, with many neurologists initially prescribing levetiracetam, which only proved effective for about 25% of patients on their first try.

Led by Dr. Jacqueline French, the research underscores the importance of patience and tailored treatment plans in managing focal epilepsy. Dr. French suggests that clinicians might need to reconsider their first-choice therapies, as better utilization of existing medications could improve early outcomes. The study involved multiple centers across the U.S., Europe, and Australia, with patients actively recording seizure activity and medication details over follow-up periods of three to six years.

While the results highlight the often lengthy process involved in optimizing epilepsy treatment, they also emphasize the need for ongoing monitoring and adjustments. The research team plans to further investigate why some patients do not achieve seizure freedom and how treatment strategies can be improved, emphasizing that progress doesn’t always require new drug development but can be achieved through more effective use of current options.