Increasing the dosage of pregabalin in patients with focal epilepsy decreases the frequency of seizures and ameliorates symptoms of anxiety, depression and insomnia

OBJECTIVE: The effectiveness of the treatment depends on the adequate dosage of medications. In clinical practice, drugs are often used at doses that are too low, which results in suboptimal levels of clinical improvement. The aim of the study was to evaluate the effects of increasing the dose of previously taken pregabalin in a group of patients with focal epilepsy and generalized anxiety disorder (GAD). PATIENTS AND METHODS: This open study involved 993 patients (46 +/- 14 years old) suffering from epilepsy with focal seizures and concomitant GAD treated with pregabalin add-on therapy. The severity of anxiety was assessed with GAD-7 Scale. The number of epileptic seizures was monitored before and after the increase of the pregabalin dose. RESULTS: On the initial visit, the mean daily dose of pregabalin was 159 +/- 82 mg. During the study period (nine months) the mean dose was increased to 327 +/- 163 mg. After nine months, based on the intention-to-treat analysis, 27.1% (N = 253) of the subjects experienced seizure resolution, and 57.8% (N = 539) reduction in seizure frequency by at least 50%. At the beginning of the study. despite pregabalin administration, 60.7% of patients were above the diagnostic threshold for GAD diagnosis. The add-on therapy resulted in the improvement of the depressive and anxiety symptoms, and insomnia, greater in those that experienced seizure resolution or reduction in their frequency. CONCLUSIONS: (1) Patients with focal epilepsy with concomitant anxiety disorder experience reduction in seizure frequency, improvement of anxiety, depressive symptoms and insomnia using PGB as an add-on therapy. (2) Our data suggest that pregabalin as an add-on treatment is a reasonable choice for patients with focal epilepsy who have concomitant symptoms of an anxiety disorder.