Global Antiepileptic Drug Shortages Drive Emergency Department Visits
Widespread shortages of antiseizure medications are significantly increasing emergency department visits and worsening seizure control for patients globally. This critical issue stems from complex supply chain failures, manufacturing challenges, and economic pressures, profoundly impacting patient care across multiple countries including India. The problem requires urgent, coordinated international and national interventions.
Key Highlights
- Antiseizure medication shortages directly linked to increased ED visits and seizure clusters.
- Drug shortages are a systemic, global issue affecting millions of patients.
- Patients face treatment delays, adverse events, and higher costs due to unavailable medications.
- Causes include low generic prices, complex manufacturing, and fragile supply chains.
- India, with a large epilepsy burden, faces significant challenges in medication access.
- Healthcare systems across Europe and beyond are experiencing heightened burden and costs.
Antiseizure medication (ASM) shortages are a pressing global health crisis, directly contributing to a rise in emergency department (ED) visits and compromising the health outcomes of individuals with epilepsy. A recent report in the European Medical Journal (EMJ) highlighted this critical link, presenting findings from a retrospective study in Bogotá, Colombia. The study compared seizure-related ED visits between March-May 2023 (no shortage) and the same period in 2024 (ongoing shortages). It revealed a significant increase in ED visits attributed to ASM unavailability, jumping from 6.5% to 31% during the shortage period, with a reported odds ratio of 6.4. Furthermore, patients affected by these shortages were found to be 2.43 times more likely to experience seizure clusters and showed a trend towards longer hospital stays. While mortality and ICU admissions remained stable in the study, the findings underscore how medication shortages can worsen seizure control and increase the burden on hospital emergency services.
This issue is not isolated to Colombia or Europe but reflects a systemic global challenge. The European Association of Hospital Pharmacists (EAHP) conducted a survey in 2025, confirming that medicine shortages severely affect patient care (89%) and pharmacy operations (79%) across Europe. Hospital pharmacists reported experiencing shortages of critical medicines multiple times in 2024. Similarly, a Nuffield Trust report from April 2024 characterized medicine shortages as a "new normal" in the UK, observing "constantly elevated medicines shortages" and frequent disruptions, particularly worsening in 2023. Epilepsy medicines such as Tegretol (carbamazepine) and Lamictal (lamotrigine) were consistently impacted. A UK cross-sectional survey published in November 2025 indicated that over 70% of people with epilepsy had difficulty obtaining their ASMs in the preceding year, with nearly 40% reporting that stress and anxiety caused by these shortages led to increased seizure frequency or severity.
Beyond Europe, these shortages represent a widespread problem. A global study from September 2025 found that drug shortages have become a systemic issue impacting millions of patients and healthcare systems, particularly in Europe and North America. These shortages are linked to sharp drops in medicine use, in some cases by over a third. The US Pharmacopeia (USP) in its 2024 and 2025 reports highlighted persistent drug shortages, with 89% of 2024 shortages carrying over from 2023, emphasizing their long-lasting nature. An Australian report from March 2023 also revealed that approximately one in five patients taking ASMs between 2019 and 2020 were affected by shortages, with generic brands accounting for 93% of these instances. The report noted that these findings align with global trends. Even in Germany, a December 2023 study found ASM shortages to be common and widespread, affecting generic brands more often than originator brands.
The consequences for patients are severe and multifaceted. Drug shortages lead to treatment delays, the use of less effective or more costly alternative medicines, medication errors, and increased adverse events. Patients may experience worsened illnesses, complications, and higher out-of-pocket expenses. The constant struggle to find prescribed medications also causes significant stress and anxiety for patients and their caregivers, potentially triggering more seizures. Hospitals are forced to expend additional resources, including staff time, to locate and procure alternative drugs, leading to increased institutional costs and sometimes compromising the ability to provide a full range of services.
The problem is particularly relevant to India, which bears a significant portion of the global epilepsy burden, with an estimated 12 million people suffering from active epilepsy. Despite the high prevalence, India faces a substantial epilepsy treatment gap, especially in rural areas where it can be as high as 80%. A study published in February 2026 highlights that antiseizure drug (ASD) shortages are common in Low- and Middle-Income Countries (LMICs), including India, with less than 50% availability of essential generic AEDs in public sectors. The cost of medication also poses a huge barrier, consuming over 40% of annual income for poor families, often leading to treatment discontinuation. Historical incidents, such as the acute shortage of epilepsy medicine Sabril Vigabatrin in Tamil Nadu in 2020, further underscore the vulnerability of India's supply chain. More recently, in December 2023, concerns were raised regarding the supply of 'not of standard quality' epilepsy drugs, including sodium valproate and levetiracetam, to Delhi government hospitals. These factors collectively mean that global drug shortages have a direct and profound impact on India's healthcare landscape and its epileptic patient population.
The root causes of these widespread shortages are complex and systemic. Key drivers include low prices for generic drugs, which reduce profitability and lead manufacturers to discontinue production. Manufacturing complexities, such as the need for dedicated facilities or complex chemical synthesis for active pharmaceutical ingredients (APIs), also make drugs more vulnerable to shortages. Geographic concentration of manufacturing, where critical components are sourced from limited locations, makes supply chains fragile and susceptible to disruptions from natural disasters, geopolitical instability, or trade restrictions. Regulatory issues, quality concerns at manufacturing facilities, and increased demand for certain medications (e.g., GLP-1 drugs diverting manufacturing capacity) further exacerbate the problem.
In conclusion, the EMJ article accurately highlights a critical and globally prevalent issue: antiseizure medication shortages are a significant driver of increased emergency department visits. This phenomenon is corroborated by extensive evidence from various regions, demonstrating that fragile global supply chains, economic pressures, and manufacturing challenges are leading to widespread unavailability of essential medications. The impact on patient care is severe, ranging from uncontrolled seizures and increased anxiety to higher healthcare costs and compromised quality of life. For countries like India, with a substantial epilepsy burden and existing challenges in healthcare access, these global shortages pose an even greater threat. Addressing this systemic problem requires urgent, coordinated efforts across governments, pharmaceutical industries, and healthcare providers to ensure a stable and accessible supply of life-saving medications for all.
Frequently Asked Questions
What are antiseizure medication shortages and why are they happening?
Antiseizure medication (ASM) shortages refer to the widespread unavailability of drugs essential for managing epilepsy. These shortages are driven by complex factors including low profitability of generic drugs, intricate manufacturing processes, fragile global supply chains, geopolitical instabilities, regulatory issues, and sudden shifts in demand.
How do these medication shortages impact patients with epilepsy?
Patients with epilepsy are severely affected by ASM shortages, experiencing worsened seizure control, increased frequency of seizures, and a higher risk of seizure clusters. This often leads to more emergency department visits, treatment delays, and the need for less effective or more costly alternative medications. The uncertainty also causes significant stress and anxiety for patients and their caregivers.
Is this issue specific to certain regions, or is it a global problem?
While specific studies might focus on certain regions like Europe or Colombia, the issue of antiseizure medication shortages is a recognized global problem. Reports from the US, UK, Australia, Germany, and studies on Low- and Middle-Income Countries (LMICs) consistently highlight ongoing and systemic shortages across different continents.
What is the relevance of antiseizure medication shortages to India?
India faces a significant burden of epilepsy, with approximately 12 million people affected. Antiseizure drug shortages are common in India, with less than 50% availability of essential generic ASMs in public sectors. This exacerbates a large existing treatment gap, especially in rural areas, where access and affordability of consistent treatment are major hurdles for patients.
What steps are being taken to address these medication shortages?
International bodies and national governments are increasingly recognizing the severity of drug shortages. Efforts include enhancing coordination among European institutions and member states, strengthening solidarity in supply chains, and developing strategies to improve supply chain resilience. However, the problem remains persistent, necessitating more comprehensive and coordinated approaches to prevent new shortages and resolve existing ones.