The use of generic medications is economically justified and in many countries it is legally allowed to switch anti-epileptic medications at the pharmacy. However, there are several reports indicating clinical risks associated with a change from the original anti-epileptic to a generic or from one to another generic drug.

Most individuals (63%) claimed that they had never bought a generic substitute. In a subgroup declaring that a switch had been proposed to them in the pharmacy (~40%), only 68.7% of subjects received some explanation from a pharmacist, and only 17.7% of subjects reported positive emotions mostly related to a lower price of new drug and explanations received. Most respondents who accepted the pharmacy switch (67.4%) did not notice significant changes in efficacy and tolerability of treatment, while the remaining subjects reported an increase in seizure frequency (23.2%) and deterioration in treatment tolerance (2%).

Around 40% of Polish epilepsy patients have been confronted with a proposal to switch their anti-epileptic medications in the pharmacy. More of these patients report negative attitudes towards the pharmacist’s proposal. It is possible that one of the major reason of the patients’ negative attitudes is insufficient amount of information provided by pharmacists. It remains to be established whether decrease in seizure control reported by 23.2% of subjects could be justified by a low concentration of anti-epileptic drug after the switch.