<b>Evaluating the Efficacy of Adjunctive Non-Pharmacological Interventions in Reducing Seizure Frequency among Patients with Epilepsy.</b>

Background: Epilepsy is a chronic neurological disorder that often requires long-term treatment to achieve adequate seizure control. Although antiepileptic drugs remain the primary therapy, a considerable proportion of patients continue to experience recurrent seizures despite stable pharmacological management. Growing attention has been directed toward non-pharmacological strategies that target modifiable lifestyle and behavioral factors contributing to seizure occurrence. However, evidence from controlled studies evaluating their additive benefit alongside standard therapy remains limited. Objective: To compare the effectiveness of adjunctive non-pharmacological interventions versus standard therapy alone in reducing seizure frequency among patients with epilepsy. Methods: A randomized controlled study was conducted in a clinical setting in South Punjab. Sixty adult patients with epilepsy and persistent seizures despite stable antiepileptic therapy were randomly allocated into two equal groups. The control group received standard pharmacological treatment, while the intervention group received standard therapy combined with structured non-pharmacological interventions, including stress management, sleep hygiene counseling, lifestyle modification, and guided physical activity. Seizure frequency was recorded using patient-maintained seizure diaries at baseline and during follow-up. Data were analyzed using parametric statistical tests, with comparisons made within and between groups. Results: Baseline seizure frequency was comparable between groups. Following the intervention period, the intervention group demonstrated a marked reduction in mean monthly seizure frequency compared with the control group. Within-group analysis showed a statistically significant reduction in seizure frequency in the intervention group, while the control group exhibited a smaller reduction. No intervention-related adverse events were reported. Conclusion: Adjunctive non-pharmacological interventions, when combined with standard antiepileptic therapy, were associated with a greater reduction in seizure frequency. These findings support the integration of structured non-pharmacological strategies into comprehensive epilepsy management.