How do you counsel patients on anti-seizure medication necessity (or lack thereof) in the setting of PNES without comorbid epilepsy?

I discuss in detail and openly with the patients regarding the etiology of epileptic seizures in comparison with the current understanding of etiology in PNES and help them understand why traditional anticonvulsants won't work for PNES. I also explain that taking a medication that may not be indicated exposes a patient to risk without any clear benefit. The vast majority of patients are happy to titrate off medications that they don't need. In the rare instances in which a patient refuses to titrate off medication, I find a slow approach, revisiting the diagnosis and the topic multiple times over several visits while building rapport may be a better long-term solution than stopping medications against a patient's will unless there is an acu...