Discrepancy in ATCs for gabapentinoids between Taiwan and the WHO

Update 2025 04 02 Owen Yang

Since its approval in the US in 1999, Levetiracetam gradually gained its place into clinical medicine, from being the first-line focal seizure and an adjunctive tonic-clonic seizure therapy, to the first-line treatment for more refractory or maintanence medication for status epilepticus. A recent report also suggest a substantial use of Levetiracetam in Taiwan.

In Prescribing in Taiwan, Levetiracetam is grouped under Other anti-epileptics (Oral, Injections) (#N03AX) , which includes levetiracetam, lamotrigine, but also gabapentin and pregabalin that could be used in seizure but more for pain. Different from this Taiwan source, in the updated WHO ATC there is a separate category for gabapentinoid (#N02BF) and the old category #N03AX does not include gabapentinoids.

It is probably better to separate these drugs in future updates, but for now this drug group has included a few drugs together and all could be of separate interest.