title: A trial of discontinuation of barbiturates in patients with secondary generalized epilepsy.
abstract: The vast majority of patients with secondary generalized epilepsy (SGE) were under polytherapy including barbiturates. We were able to completely withdraw barbiturates in 17 cases with a refractory course of SGE. Valproic acid (VPA) is considered as one of the best drugs for SGE. Barbiturates decrease the serum level of VPA and this may lead to a reduced efficacy of VPA. The dosage of VPA was adjusted to attain the level of 100-150 micrograms/ml. Barbiturates were then gradually decreased and finally discontinued. After six months of follow-up, 13 patients (76%) showed a reduced seizure frequency. Also, the physical and psychological conditions improved in a good number of cases. Barbiturates are not necessarily required in pharmacotherapy of SGE and may be safely withdrawn.
mesh_terms: D000293:Adolescent; D000328:Adult; D000641:Ammonia / Q000097:blood; D001463:Barbiturates / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004828:Epilepsies, Partial / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D014635:Valproic Acid / Q000008:administration & dosage / Q000097:blood
chemical_list: D001463:Barbiturates; D014635:Valproic Acid; D000641:Ammonia