Drug-resistant epilepsy (DRE), also known as refractory epilepsy, is a condition where seizures in patients do not respond to standard anti-seizure medications. It affects around 30% of people with epilepsy, making it a challenging and concerning issue. Despite trying multiple drugs, these individuals continue to experience seizures, affecting their daily lives and quality of life.
Management options for drug-resistant epilepsy include alternative medications, dietary therapies like the ketogenic diet, and surgical interventions, such as brain surgery or neuromodulation. People with drug-resistant epilepsy need to work closely with healthcare professionals to find the most suitable treatment plan and improve their seizure control.
Clinical Trial
The Modified Atkins diet (MAD) has emerged as a potential adjuvant therapy for DRE, particularly in children. However, the evidence supporting its use in adults remains limited. To address this gap, a prospective randomized controlled clinical trial was conducted at a tertiary care referral center.The study investigated whether MAD, combined with standard drug therapy (SDT), was more effective than SDT alone in reducing seizure frequency and improving psychological outcomes in adolescents and adults with DRE (nonsurgical cases). Between August 2015 and April 2019, 243 patients with DRE aged 10-55 were screened for eligibility. Out of these, 160 patients (80 adults and 80 adolescents) were randomly assigned to either the intervention arm (SDT plus MAD) or the control arm (SDT alone).
At the start of the trial, both groups had comparable demographic and clinical characteristics. The primary outcome assessed was whether there was a >50% reduction in seizure frequency at six months. The secondary outcomes included measuring the patient's quality of life (QOL), behavioral changes, adverse events, and withdrawal rate from the study.