Consequences of outpatient antiseizure medication shortages in the emergency department

Objective: Shortages of antiseizure medications (ASM) have been increasingly reported worldwide, threatening treatment continuity for patients with epilepsy. Since 2024, Colombia has experienced a nationwide shortage of medications for neurological diseases, particularly ASM, compromising disease control and healthcare outcomes. This study evaluated the impact of outpatient ASM shortages on seizure-related emergency department (ED) visits in a public hospital in Bogotá, Colombia. Methods: We conducted a retrospective, descriptive study of adult patients with epilepsy admitted to the ED between March–May 2023 (no shortage) and March–May 2024 (shortage period). Demographic, clinical, and hospitalization data were collected from medical records. Statistical analyses included Fisher's exact and Mann–Whitney U tests, with significance set at p <.05. Results: A total of 281 patients were included (107 in 2023, 174 in 2024). Sixty-one admissions were directly related to lack of outpatient ASM (7 in 2023, 54 in 2024). ED visits due to ASM unavailability increased from 6.5% to 31% (p <.001; OR = 6.4; 95% CI 2.7–17.4). Patients affected by shortages showed a higher risk of seizure clusters (OR = 2.43; 95% CI 1.2–5.1; p =.012) and a trend toward longer hospital stays, though mortality and ICU admissions remained unchanged. Significance: Outpatient ASM shortages were associated with a marked rise in seizure-related ED visits and an increased risk of seizure clusters, reflecting greater hospital burden. Ensuring stable ASM supply through effective national distribution and monitoring strategies is essential to maintain seizure control and prevent avoidable complications in patients with epilepsy.