The substitution of brand-name antiepileptic drugs with cheaper generic equivalents has been an ongoing point of contention among doctors, federal officials and people with epilepsy.
The U.S. Food and Drug Administration claims generic antiepileptic drugs have the same dosage, purity and strength as their brand-name counterparts and the two are interchangeable. But doctors and people with epilepsy remain concerned, citing widespread reports of individuals suffering seizures after switching medication.
A new comprehensive review by pharmacists and doctors at the University of Connecticut and Hartford Hospital shows that it is not the anticonvulsant drugs themselves, but the switching aspect that may be causing the problem.
In a review of 89 different studies dating back to 1950, the researchers found that the efficacy, tolerability and safety of brand-name and generic antiepileptic medications are virtually the same. But switching from one form to the other may cause patients to have more hospitalizations and longer hospital stays. The study results were first reported in a Comparative Effectiveness Review issued by the Agency for Healthcare Research and Quality (AHRQ) in December 2011.
"If you have epilepsy and want to start on an antiepileptic drug, the evidence is compelling that it doesn't matter if you use a brand- name or a generic product. But if you're already using one version of drug (generic or brand-name), there may be a concern if you switch to something else," says C. Michael White, a pharmacy professor at the University of Connecticut and director of the federally-designated UConn/Hartford Hospital Evidence-Based Practice Center in Hartford, Conn.
The same concerns apply whether a person switches from a brand-name drug to a generic version or from one generic version to another, White says. While many individuals with epilepsy may not experience any problems switching medications, some people may have c
|Contact: C. Michael White|
University of Connecticut