Priority 2 from the Epilepsy (Canada) PSP

UNCERTAINTY: What are the impacts of long-term use of anti-seizure drugs, the causes of side effects of these treatments and how can we prevent the side effects? (JLA PSP Priority 2)
Overall ranking	2
JLA question ID	0110/2
Explanatory note	All anti-seizure drugs (ASDs) have possible side effects, most of which are well-known. However, the impact of taking these drugs for long periods of time, or a lifetime, is unclear. Researchers are still trying to understand the cumulative effect of ASDs on physical and mental health, and how these effects change over time. Examples include effects on bone health, hormonal systems, reproductive systems, cognition and behaviour, and the digestive system (including the liver, which metabolizes many ASDs). Side effects can have a significant impact on quality of life, and can also affect drug adherence. Clear strategies to minimize and manage side effects by modifying medications or dosing still need to be developed.
Evidence	Evidence Not Identified
Health Research Classification System category	Neurological

Extra information provided by this PSP
Original uncertainty examples	What is the long term impact on a developing brain of being on anti-seizure medication? ~ What is known about the long term effects of taking a cocktail of epilepsy drugs over a lifetime? What is the impact in longevity? When do scientists predict there will be a cure? ~ What is the long term effectiveness of medication-based treatments? Are there risks to being on the medications long term?
Submitted by	People with Seizures x 39, Caregivers x 8, Friend or Family Member x 15, Health Care provider x 1, Community Agency Representative x 2, Other x 3

PSP information
PSP unique ID	0110
PSP name	Epilepsy (Canada)
Total number of uncertainties identified by this PSP.	96 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	6th & 7th April 2021