ABSTRACT
Loss of seizure control in a seizure-free patient or a substantial increase in seizure frequency may be catastrophic for a person with epilepsy. Many jobs are closed to persons whose seizures are incompletely controlled, and even more are closed to persons whose seizures are frequent. The skyrocketing cost of medical care has led to the suggestion that generic equivalents of various medications, which cost on the average 30% less than the brand-name product, be allowed as substitutes. In the United States some states have required such substitutions, and others have allowed pharmacists to make such substitutions without consulting the prescribing physician. The problem with inequality of generic antiepileptic drug (AED) is compounded by the fact that generic preparations are not identified by the manufacturer and pill color and shape are rarely distinctive. Many patients with epilepsy do equally well or badly in spite of shifts in AED preparation.
