A patient who takes carbamazepine (Tegretol) has been seizure-free for 2 years and asks the primary care NP about stopping the medication. The NP should:
a. order an electroencephalogram (EEG).
b. prescribe a tapering regimen of the drug.
c. inform the patient that antiepileptic drug (AED) therapy is lifelong.
d. tell the patient to stop the drug and use only as needed.
A
Discontinuation of AEDs may be considered in patients who have been seizure-free for longer than 2 years. An EEG should be obtained before the medication is withdrawn. The drug should be tapered to prevent status epilepticus, but only after a normal EEG is obtained. AED therapy is not lifelong in all patients. Patients should not stop AED medications abruptly, and these drugs are not used on an as-needed basis.
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