Reducing the number of anticonvulsant drugs taken by severely retarded epileptic patients.

Recent reports imply potential benefits to patients taking longterm, multiple anticonvulsants if the number of concurrent drugs could be safely reduced. Attempts to reduce the doses of one anticonvulsant were made at monthly intervals in a selected group of 33 closely supervised, ambulatory, chronic epileptic patients with severe mental retardation. Phenytoin dosage was increased in over half the patients as the other drug was decreased. Over 18 months of observation, phenobarbital was completely withdrawn from 19 patients, primidone from four, ethosuximide from one and phensuximide from one. There was no deterioration of behavior or loss of seizure control in these patients. Seizures reappeared after a year in five patients who continued to take phenytoin after phenobarbital or primidone was withdrawn. A second anticonvulsant was given to these patients. This study shows that one anticonvulsant can be successfully withdrawn from many, but not all, chronic epileptic patients with multiple handicaps.