Objective: Epilepsy is a common disease and can be treated with anti-epileptic drugs (AEDs). This study aimed to evaluate trends and cost of AEDs use in university hospital, Thailand.

Materials and Methods: This was a retrospective descriptive study conducted at Srinagarind Hospital, a university hospital of Khon Kaen University. The inclusion criteria were patients with epilepsy who received AEDs both new and standard categories. The study period was between 2015 and 2021. Trends and costs of AEDs were reported and categorized as new and standard AEDs.

Results: There were nine new and 6 standard AEDs prescribed during the study period.  There were 958968 prescribed tablets for the new AEDs with the total cost of 37143927.25 Baht, while there were slightly more prescribed standard AED (1818049 tablets) with the total cost of 10689034.75 Baht. For the new AEDs group, three common AEDs were lamotrigine, levetiracetam and topiramate with an increasing trend. For the standard AEDs group, sodium valproate and phenytoin had decreasing trend. 

Conclusion: The new AEDs had an increasing trend particularly lamotrigine, levetiracetam, and topiramate resulting in higher costs than the standard AEDs.