Medication switches need to be shared

By David B. Moore

More than 30,000 people live with epilepsy in Iowa. Slight changes in their medications can have detrimental effects and terrible consequences, including death. As a doctor specializing in treating people with this neurological disorder, I want to draw attention to an issue that affects my patients and to ask your support in helping Iowans with epilepsy receive the best treatment available to them.

In my 20 years of clinical practice, I have learned one thing: For the successful management and treatment of this condition, communication among patients, physicians and pharmacists is essential. There is no margin for error in treating patients with epilepsy. I know this not only as a doctor but also as one living with epilepsy.

There is a serious problem we are facing. Substitution of patients' prescribed epilepsy medications without the knowledge and permission of the doctor and patient puts these patients' lives at risk. I have seen this happen too many times.

The good news is that there is a solution. We must increase communication between patients, doctors and pharmacists. This solution starts at the Statehouse. The Legislature is considering House File 2410, a bill that would ensure patients and physicians be notified if any switch is made regarding their anti-epileptic medication. House File 2410 is good legislation - limited in scope, but one which will take a step at significantly protecting the lives of thousands of Iowans, while improving the physician-pharmacist-patient relationship.

I want to be clear: Some substitutions of medications - including generics – are a useful tool to cut costs and to keep patients healthy.

But for Iowans with epilepsy, the substitution of drugs without the knowledge of the doctor and patient can cause severe problems. Let me give you a real-world example.

An otherwise healthy 33-year-old woman came to me for treatment. I prescribed her a drug I felt to be medically necessary. However, several months into our treatment plan, her seizures increased dramatically. This was a direct result from substituting one brand drug to an alternative brand drug. This was done without the consent of my patient and without my knowledge.

HF 2410 should be given a fair chance and serious consideration this legislative session.

For more information, contact the Epilepsy Foundation of America, toll-free at 1-(800) 332-1000.

Dr. David B. Moore is chairman of the Department of Neurology, McFarland Clinic, and director of Neurophysiology, Mary Greeley Medical Center, Ames.