For professionals referring to the epilepsy nurse specialist liaison service

Referring your patient

Patients need to be 16yrs old or over
Patients need to have been reviewed by a Sheffield Teaching Hospitals NHS Foundation Trust neurologist within the past five years
Patients need to have a GP in the Sheffield, Chesterfield or Rotherham area

Shared care protocol

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Contact details:

For use by Health care professionals only: 0114 271 3488
Email: sth.epilepsyserve@nhs.net

Teaching and training

We do offer Epilepsy Awareness Training. Please email our service at sth.epilepsyservice@nhs.net for more information

Guidelines

Here are some useful guidelines in relation to adults with epilepsy.

What does the MHRA guidance say?

The guidance divides AEDs into three categories according to the importance of maintaining a consistent supply and depending on whether there is considered to be a risk of problems if switching between different versions.

Category 1:

Phenytoin, carbamazepine, phenobarbital and primidone.
Specific measures are necessary to ensure consistent supply of a particular product.
This means that individuals should not be switched between versions of these AEDs, but should always be kept on the same version.

Category 2:

Sodium valproate, lamotrigine, perampanel, retigabine, rufinamide, clobazam, clonazepam, oxcarbazepine, eslicarbazepine acetate, topiramate and zonisamide.
The need for continued supply of a particular product should be based on ‘clinical judgement’ (the doctors judgement of the risk of problems) and in consultation with the individual.
This means that a doctor should decide, with the individual, whether it is important to always stay on the same version or whether it is ok to switch between different versions.

Category 3:

Levetiracetam, lacosamide, tiagabine, gabapentin, pregabalin, ethosuximide and vigabatrin.
No specific measures are normally required and these AEDs can be prescribed generically.
This means that individuals can be switched between different versions of their AEDs.