MEDICATION USE, SELF-REPORTED DRUG ALLERGIES, AND ESTIMATED MEDICATION COST IN PATIENTS WITH EPILEPTIC VERSUS NONEPILEPTIC SEIZURES

The decision to take medication may say as much about a patient's self -perception as it does about his or her diagnosis. Patient-reported dr ug allergies often cannot be verified by physicians, and may be a self -perception not always grounded in medical reality. We retrospectively studied medication use and self-reported drug allergies in 346 sequen tial epilepsy monitoring unit (EMU) inpatients from 1994-96. Because f inancial concerns play an increasing role in patient care, we also est imated minimum antiepileptic drug (AED) costs. A clear diagnosis was r eached in 226/346 (65%) cases. Seventy-four cases were nonepileptic se izures (NES) (33%) and 152 were epileptic seizures (ES) (67%). The NES patients were significantly more likely to be women (76%) than were E S patients (60%) (p < 0.01). The NES and ES patients took an average o f 3.6 and 3.3 medications, respectively, at baseline (p > 0.05). The B S patients took more AEDs than NES patients [1.9 and 1.3, respectively (p < 0.01)]. Conversely, NES patients took more non-AEDs at baseline [2.3 vs. 1.4 (p < 0.01)]. The NES patients reported more drug allergie s than did ES patients [1.1 vs. 0.8 (p < 0.05)]. Minimum average estim ated AED costs for NES patients were $70.04 per month, and for ES pati ents were $104.22. The tendency to take more medicines and reported mo re drug allergies by NES patients may reflect a greater tendency to ma nifest psychologic distress as physical symptoms. This comes at a high cost, with minimum estimated cost of $70 per month. (C) 1998 by Elsev ier Science Lnc. All rights reserved.