Unnecessary polypharmacy in patients with frequent seizures.
35 patients with a mean seizure frequency of 15 attacks per months were studied. 19 were taking a 2-drug combination, 13 a 3-drug combination and 3 patients a 4-drug combination. Treatment was reduced to monotherapy in 21 patients and to a 2-drug combination in 8 patients. There was an increase in seizure frequency in 6 patients taking a 2-drug combination when an attempt was made to reduce the treatment to monotherapy. Reduction in polypharmacy resulted in an improvement in seizure control in 54% of patients. Carbamazepine replaced polypharmacy as monotherapy in 19 patients and phenytoin and sodium valproate in 2 other patients. Improvement in seizure control was associated with optimal blood levels in 17 patients taking carbamazepine and in the 2 patients taking sodium valproate and phenytoin. Serum levels in all patients taking 2-drug combination were within the optimal range.
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage*; D002220:Carbamazepine / Q000008:administration & dosage; D002648:Child; D002998:Clonazepam / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy*; D005013:Ethosuximide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D010634:Phenobarbital / Q000008:administration & dosage; D010672:Phenytoin / Q000008:administration & dosage; D011324:Primidone / Q000008:administration & dosage; D014635:Valproic Acid / Q000008:administration & dosage
D000927:Anticonvulsants; D011324:Primidone; D002220:Carbamazepine; D002998:Clonazepam; D005013:Ethosuximide; D014635:Valproic Acid; D010672:Phenytoin; D010634:Phenobarbital