OBJECTIVES: To examine the likelihood of initiating medications approved to treat various psychiatric conditions among patients with focal seizures (FS) receiving first-line (1L) eslicarbazepine acetate (ESL) or levetiracetam (LEV).

METHODS: This retrospective study used Symphony Health’s Integrated Dataverse (IDV^®) claims data to identify patients ≥4 years of age diagnosed with FS who had a new prescription for 1L ESL or LEV between April 2015 and June 2018. Index date was the earliest dispensed claim for ESL or LEV. Patients had no claims for medications approved to treat psychiatric conditions in the 3 months prior to index date. Study measures were baseline demographics (e.g. age, sex) and clinical characteristics (e.g. comorbidities) recorded during the 3 months prior to index date. Claims for medications approved to treat various psychiatric conditions during the 6 months following index date were analyzed. Likelihood of initiating medications approved to treat psychiatric conditions ogistic regression models.

RESULTS: 225 and 23,797 patients received 1L ESL or LEV, respectively. Among patients who received 1L ESL, mean age was 44.4 (±18.2) years, 58.7% were female, 36.0% had a neurological disorder, and 12.4% had developmental and psychiatric disorders. Among patients who received 1L LEV, mean age was 50.4 (±23.4) years, 50.2% were female, 56.1% had a neurological disorder, and 22.9% had developmental and psychiatric disorders. Relative to patients receiving 1L LEV, patients receiving 1L ESL had a lower likelihood of initiating medications approved to treat psychiatric conditions (odds ratio: 0.72; 95% confidence interval: 0.52-0.98).

CONCLUSIONS: Patients with FS receiving 1L ESL had a lower likelihood of initiating medications approved to treat psychiatric conditions.