Discontinuation of antiepileptic drugs in adults with epilepsy

Patients with epilepsy who have been free of seizures for at least two years may be able to stop their antiepileptic drugs. Discontinuation may be considered after an individualised harm–benefit assessment and consultation with a neurologist is recommended. It is paramount to discuss with patients whether the risk of seizure recurrence is worth the benefit of stopping the antiepileptic drug. The risk of seizure recurrence after antiepileptic drugs are discontinued depends on the epilepsy syndrome and a number of other risk factors. Approximately 30–50% of patients will relapse. If seizures recur, the majority of patients regain seizure control when treatment is resumed. However up to 20% do not achieve immediate remission.