Outcomes After Planned Discontinuation of AntiSeizure Medication

The researchers will observe the number of patients who consented divided by the number of patients who were eligible

the number of patients who tapered off their antiseizure medication (ASM) within 2 months of consent or started tapering off their ASM but had a seizure before being able to fully taper off

This will entail a 30-minute qualitative discussion with the patient and caregivers if applicable to receive any feedback about study procedures. The study will ask patients and caregivers what went well, what could be improved, what participants thought of recruitment and retention and data collection procedures, and the intervention. Responses will be purely qualitative via a discussion with the patient and summarized.

This is a survey of health-related quality of life for adults aged ≥18 years diagnosed with epilepsy. The self-reported questionnaire contains 7 multi-item sub-scales that cover the following health concepts: emotional well-being, social functioning, energy/fatigue, cognitive functioning, seizure worry, medication effects, and overall quality of life. A total of 31 items are measured using Likert scales and scored by weighting and summing each item. The score ranges 0-100, with higher scores indicating better quality of life.

This is a 21-item multiple-choice self-report inventory used to measure the severity of depression symptoms according to criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Items include statements relating to sadness, pessimism, past failure, loss of pleasure, guilty feelings, punishment feelings, self-dislike, self-criticalness, suicidal thoughts or wishes, crying, agitation, loss of interest, indecisiveness, worthlessness, loss of energy, changes in sleeping pattern, irritability, changes in appetite, concentration difficulty, tiredness or fatigue, and loss in interest in sex. Participants will respond to each item based on a 2-week time period, using a 4-point scale from 0 to 3. A score of 0 to 13 indicates minimal depression, 14 to 19 indicates mild depression, 20 to 28 moderate depression, and 29 to 63 indicates severe depression.

The GAD is a 7-item self-reported screening tool that measures the severity of generalized anxiety disorder symptoms. The 7 items assess feeling nervous/anxious, being able to stop worrying, worrying too much, trouble relaxing, being restless, becoming easily annoyed/irritable, and feeling afraid something awful might happen. Participants will respond to each item based on a 2-week time period, using a 4-point scale from 0 to 3. A score of 0 to 4 indicates minimal anxiety, 5 to 9 indicates mild anxiety, 10 to 14 indicates moderate anxiety, and 15 to 21 indicates severe anxiety.

The Patient Global Impression-Change scale is a self-reported scale that will be used to assess perception of change in participants overall status since baseline using a 7-point Likert scale, anchored at 1= "very much improved" and 7= "very much worse".

This measures recognition memory for words. Fifteen words are presented, one by one, on the screen every 2 seconds. For immediate recognition, the participant has to identify those words nested among fifteen new words. The test is scored by the number of correct hits out of 15.

Verbal memory delayed recall: After 6 more tests, there is a delayed recognition trial of the original words from the immediate recall test. The test is scored by the number of correct hits out of 15.

This measures recognition memory for figures or shapes. The protocol is similar to the verbal memory test. Fifteen geometric figures are presented, one by one, on the screen. For immediate recognition, the participant has to identify those figures nested among 15 new figures. The test is scored by the number of correct hits out of 15.

Visual memory delayed recall: The protocol is similar to the verbal memory test. After 5 more tests, there is a delayed recognition trial. The test is scored by the number of correct hits out of 15.

This test consists of serial presentations of screens, each of which contains a bank of 8 symbols above and 8 empty boxes below. The participant types in the number that corresponds to the symbol that is highlighted. Only the digits 2-9 are used, to avoid confusion between "1" and "I" on the keyboard. The computer program does not allow a person to use a numerical pad, preventing a distinct advantage for those who are skilled at using the numerical pad or for those that are right- versus left-handed. Tasks continue for about 4 minutes. The test is scored as the number of correct responses within the time limit, ranging from 0 to as many correct responses as they can achieve.

This is a measure of ability to shift from one instruction set to another quickly and accurately. Participants are instructed to match geometric objects either by shape or by color. Three figures appear on the screen, one on top and 2 on the bottom. The top figure is either a square or a circle. The bottom figures are a square and a circle. The figures are either red or blue (mixed randomly). The participant is asked to match one of the bottom figures to the top figure. The rules change at random (i.e., match the figures by shape, for another, by color). The task continues for about 2.5 minutes. The test is scored as the number of correct responses and errors within the timeframe, ranging from 0 to as many correct responses as participants can achieve.