Association between complementary and alternative medicines (CAM) usage and self-perceived cognitive impairment among epilepsy patients

Context: Patients with epilepsy may experience a broad range of cognitive impairments. Self-reporting of symptoms may be confounded by the limited insight of cognitive problems, anxiety, concerns about the safety of AEDs and cultural norms which may lead to reliance on other therapies. Aims: This study aimed to evaluate self-perceived cognitive impairment and its association with CAM usage among epilepsy patients. Settings and Design: A cross-sectional survey was performed in 100 patients diagnosed with epilepsy at the Neurology clinic. Patients aged 18 years or older, without documented physical or psychiatric illness such as schizophrenia and major depression, were included. Methods: Self-administered questionnaire was used to assess CAM usage. An established questionnaire was used to determine subjective cognitive impairment. Statistical Analysis Used: Data were analyzed using descriptive and inferential analysis. Results: Prevalence of self-perceived cognitive impairment was found to be at 31%. More than half of patients reported moderate/severe problems in fatigue, slowing, and memory categories. The prevalence of CAM usage was found to be at 58%. CAM use was more frequent in males (32%) as compared to females (26%; p = 0.609). The most commonly used CAM included vitamins and minerals (36%), ginseng (16%), antioxidants (15%), and acupuncture (12%). The reasons for CAM usage were cheaper price, easier availability, and inadequate seizure control by AEDs. A significant association was found between subjective cognitive impairment and CAM usage (p<0.01). Conclusions: A high prevalence of CAM usage among epilepsy patients was identified. There was a significant association between CAM usage and patient self-perceived cognitive impairment.