New antiepileptic drug safety information is not transmitted systematically and accepted by U.S. neurologists

- We surveyed U.S. neurologists' knowledge of FDA safety warnings for AEDs.
- Respondents received safety information nonsystematically from multiple sources.
- One-fifth did not recognize recently identified, serious AED safety risks.
- FDA-recommended pharmacogenomic screening for carbamazepine was not carried out.
- Neurologists would prefer receiving FDA safety updates via specialty organizations.

We surveyed U.S. neurologists in order to evaluate their knowledge of, and sources for, recent FDA safety warnings regarding antiepileptic drugs (AEDs) and whether they incorporate this information into their practices. Survey respondents (N = 505) were predominantly board-certified American Academy of Neurology members. Approximately 20% of respondent neurologists were not aware of warnings about four drug safety risks: suicidality with newer AEDs, increased birth defect risks from in utero divalproex exposure, impaired cognitive development from in utero divalproex exposure, and the requirement of haplotype screening in patients of Asian descent starting carbamazepine. Most respondents were aware of a recommendation for haplotype screening, yet did not routinely perform the safety screening, and 18 reported patients that had hypersensitivity reactions to carbamazepine. Respondents learned about drug safety risks from varied sources; only notifications from specialty organizations were associated with accurate knowledge of drug safety warnings. Most surveyed neurologists would prefer implementing “a formal warning process via specialty organizations” with e-mails of updated product insert warnings.