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Letters Antiepileptic drugs

New advice on switching antiepileptic drugs might be a false economy

BMJ 2013; 347 doi: (Published 16 December 2013) Cite this as: BMJ 2013;347:f7471
  1. Emily Holmes, research fellow1,
  2. Catrin Plumpton, research officer1,
  3. Martin Duerden, senior clinical lecturer in health technology assessment1,
  4. Tony Marson, professor of neurology2,
  5. Dyfrig Hughes, professor of pharmacoeconomics1
  1. 1Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor LL57 1UT, UK
  2. 2University of Liverpool and Walton Centre NHS Foundation Trust, Liverpool, UK
  1. e.holmes{at}

Advice from the Medicines and Healthcare Products Regulatory Agency (MRHA) on switching between different manufacturers’ products for a particular antiepileptic drug may have unintended consequences.1 2 In a move to allay concerns about the potential loss of seizure control when switching products, the MHRA’s classification of these drugs according to their pharmacokinetic and pharmacodynamics properties may encourage switching—for cost …

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