The management of epilepsy in a hospital for people with a learning disability.
The study examined changes in the use of antiepileptic drugs (AEDs) in a large hospital for people with a learning disability over a 2 year period, the use of investigations, and the presence of medication side-effects. The surveys were carried out in 1993 and 1995/6. In 1993, 27% of patients were being treated for epilepsy and in 1995/6, 30.1%. Ninety percent and 82.4% of patients, respectively, were receiving one or two AEDs. In the second survey there were fewer prescriptions for phenobarbitone (5.8% vs. 12.5%) and an increase in the use of lamotrigine (21.6% vs. 5%), gabapentin (5.8% vs. 0) and vigabatrin (3.9% vs. 2.5% in 1993). Side-effects were recorded in 6 (11.8%) patients. Seven (21.2%) patients receiving carbamazepine were found to have hyponatraemia. Of the 54 electroencephalograms (EEGs) requested, 41 (76%) were reported as abnormal. Six CT brain scans had been conducted, of which five were abnormal. People receiving antipsychotic drugs had fewer seizures than average.
Carvill
S
S
Senior Registrar in Psychiatry of Learning Disability, Monyhull Hospital, Monyhull Hall Road, Kings Norton, Birmingham, B30 3QB, UK.
Clarke
D
D
Cassidy
G
G
D000085:Acetates / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000588:Amines; D000927:Anticonvulsants / Q000627:therapeutic use*; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids; D004363:Drug Utilization / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D000077206:Gabapentin; D006306:Health Surveys; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D000077213:Lamotrigine; D007859:Learning Disabilities / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010634:Phenobarbital / Q000009:adverse effects / Q000627:therapeutic use; D014227:Triazines / Q000627:therapeutic use; D006113:United Kingdom; D020888:Vigabatrin; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives / Q000627:therapeutic use
D000085:Acetates; D000588:Amines; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D014227:Triazines; D002220:Carbamazepine; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D020888:Vigabatrin; D000077213:Lamotrigine; D010634:Phenobarbital