Meeting of epilepsy experts

Abstract

It is estimated that approximately 70 million people live in the world with epilepsy, of which 80 °% live in low-or middle-income countries such as Colombia. Despite this, people with epilepsy live with unmet needs as, eventhough epilepsy is a prevalent disease, it is not reflected in the priorities of health services.

This is why there are important challenges in the comprehensive treatment of epilepsy. Epilepsy is a stigmatized disease that, beyond pharmacological expenses, has a psychological and social impact that results in a very varied spectrum of disability, suffering from notable depressions such as depression and anxiety. Likewise, people with epilepsy have a lower employment rate than people without epilepsy even up to 8 years after starting pharmacological therapy.

The crisis-free state, which is one of the main objectives in the therapy of epilepsy, is difficult to achieve in some patients and although the amount of anticonvulsant drugs has increased markedly since 1990, the crises can be generated from multiple mechanisms, which translates into a challenge when looking for therapeutic targets for medications since several etiologies can be translated clinically into similar types of crisis. Although monotherapy is the ideal treatment in epilepsy, the priority is to achieve a reduction in ictal frequency or a crisis-free state, so if it is not achieved with the first medication, the option of adding a second medication is fully accepted. .

There is a great concern about the use of generic drugs, copy or multi-source and originals since the concentration and absorption is very important for their effectiveness and safety and it is known that they should not vary more than 5-10 % to avoid Changes in the ictal pattern of patients. It has been considered that the change to generic or multi-source drugs is associated with changes in the safety profile and changes in the ictal pattern, in addition to an increase in the use of health services and a high rate of change to brand-name drugs, which could increase health costs.

For all of the above, it is considered that optimal care for patients with epilepsy refers to an interdisciplinary management in which access and follow-up are guaranteed, for which challenges such as training of personnel in primary care and health care should be accepted. continuity of management to avoid changes in bioavaila-bility, safety profile and drug toxicity.