# Neurologists’ insights and practices on generic antiepileptic medications in epilepsy management: A Saudi Arabian perspective

## TL;DR

This study explores Saudi Arabian neurologists' views on using generic epilepsy medications, finding concerns about their effectiveness and safety compared to brand-name drugs.

## Contribution

The study provides new insights into neurologists' perceptions and practices regarding generic antiepileptic drugs in Saudi Arabia.

## Key findings

- Half of the neurologists are concerned about substituting brand-name AEDs with generics.
- Strong positive correlations exist between concerns, aversion, and withholding of generic AEDs.
- More experienced neurologists are more likely to withhold generic AEDs.

## Abstract

This study aimed to investigate neurologists’ perceptions and practices regarding generic antiepileptic medications (AEDs) in the management of epilepsy, and whether generic AEDs can be used as a satisfactory, effective, and safe substitute for brand-name medications in targeted patients.

This questionnaire based cross-sectional study was performed in the Department of Medicine (Neurology Division), College of Medicine, King Saud University, Riyadh, Saudi Arabia, from July 2022 to July 2024. One hundred thirty neuro physicians participated, and 114 completed the questionnaire, yielding a response rate of 87.7%. The participants consisted of 63.2% males and 36.8% females. The questions were based on a 3-point Likert scale.

The results revealed that all four components were strongly and positively correlated with each other: the ‘Patient Miscontrol with Generic AEDs’ component had a statistically significant strong positive correlation with ‘concern About Generic AEDs’ component, r(114) = 0.654, p < 0.0005; with ‘Aversion to Generic AEDs’ component, r(114) = 0.525, p < 0.0005; and ‘Withholding Generic AEDs’ component, r(114) = 0.595, p < 0.0005. ‘Concern About Generic AEDs’ component had a statistically significant strong positive correlation with the ‘Aversion to Generic AEDs’ component, r (114) = 0.538, p < 0.0005; and the ‘Withholding Generic AEDs’ component, r (114) = 0.459, p < 0.0005. Finally, the ‘Aversion to Generic AEDs’ component showed a statistically significant positive correlation with the ‘Withholding Generic AEDs’ component, r (114) = 0.435, p < 0.0005. Spearman correlation analysis revealed a positive correlation between years of experience and ‘Withholding Generic AEDs;’ r (114) = 0.243, p = 0.009. The post hoc analysis revealed statistically significant differences between the low-experienced ‘< 5 years’ (66.50) and the high-experienced ‘> 10 years’ (100.00) groups (p = 0.014).

Half of the neurologists participating in the study are concerned about substituting brand-name antiepileptic drugs (AEDs) with generic ones. Neurologists had mixed perceptions regarding the use of generic AEDs for cost-saving purposes and the safety of substituting brand-name medications with generics. We encourage reporting every incident of seizure in patients on generic AEDs.