The risk of epilepsy is double in patients with atrial fibrillation (AF), possibly linked to silent stroke. Thus, a high proportion of patients with AF require the concomitant long-term administration of oral anticoagulation and antiepileptic therapy. Little is known about clinical interactions between antiepileptics (AEDs) and direct anticoagulants (DOACs).

In this prospective study, we found that patients with non-valvular AF treated with DOACs and antiepileptic drugs appear to have a relatively high rate of thromboembolic events.

Our findings suggest that the interaction between AEDs and DOACs might be of high clinical relevance. Indeed, caution is needed when prescribing AEDs to patients on concomitant treatment with DOACs.