title: Alternative single anticonvulsant drug therapy for refractory epilepsy.
abstract: Fifty-nine patients with chronic generalized tonic-clonic or partial seizures refractory to the maximally tolerated daily dosage of single-drug therapy with carbamazepine, phenytoin, phenobarbital, or primidone subsequently received single-drug therapy with another one of these primary anticonvulsant drugs. Alternative single-drug therapy resulted in complete seizure control or more than 75% seizure reduction for 18 patients (31%). Side effects disappeared in 16 patients (27%). Patients with a good therapeutic response often had epilepsy of recent onset. Alternative single-drug therapy is beneficial for chronic refractory epilepsy and should be considered before a second drug is permanently added.
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D002908:Chronic Disease; D004827:Epilepsy / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D010634:Phenobarbital / Q000009:adverse effects / Q000627:therapeutic use; D010672:Phenytoin / Q000009:adverse effects / Q000627:therapeutic use; D011324:Primidone / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D011324:Primidone; D002220:Carbamazepine; D010672:Phenytoin; D010634:Phenobarbital