Abstract
We performed prospective trials of phenytoin and carbamazepine, assisted by blood level monitoring, in untreated patients newly referred with grand mal or partial seizures, or both, to a neurological clinic. At the time of follow-up (mean 28.5 months for phenytoin; 12 months for carbamazepine) 76-88% of patients were completely controlled. Twelve per cent of the patients on each drug had further seizures, despite an optimum blood level. When the blood drug concentration was in the optimum range there was a 98% reduction in grand mal attack rate and 92-93% reduction in partial seizure rate. These results suggest that polypharmacy is largely, and possibly totally, unnecessary in newly diagnosed adult epileptics.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Lund L. Anticonvulsant effect of diphenylhydantoin relative to plasma levels. A prospective three-year study in ambulant patients with generalized epileptic seizures. Arch Neurol. 1974 Nov;31(5):289–294. doi: 10.1001/archneur.1974.00490410037002. [DOI] [PubMed] [Google Scholar]
- Reynolds E. H., Chadwick D., Galbraith A. W. One drug (phenytoin) in the treatment of epilepsy. Lancet. 1976 May 1;1(7966):923–926. doi: 10.1016/s0140-6736(76)92709-4. [DOI] [PubMed] [Google Scholar]
- Reynolds E. H. Chronic antiepileptic toxicity: a review. Epilepsia. 1975 Jun;16(2):319–352. doi: 10.1111/j.1528-1157.1975.tb06062.x. [DOI] [PubMed] [Google Scholar]
- Sherwin A. L., Robb J. P., Lechter M. Improved control of epilepsy by monitoring plasma ethosuximide. Arch Neurol. 1973 Mar;28(3):178–181. doi: 10.1001/archneur.1973.00490210058007. [DOI] [PubMed] [Google Scholar]
- Shorvon S. D., Reynolds E. H. Unnecessary polypharmacy for epilepsy. Br Med J. 1977 Jun 25;1(6077):1635–1637. doi: 10.1136/bmj.1.6077.1635. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Simonsen N., Olsen P. Z., Kühl V., Lund M., Wendelboe J. A comparative controlled study between carbamazepine and diphenylhydantoin in psychomotor epilepsy. Epilepsia. 1976 Jun;17(2):169–176. doi: 10.1111/j.1528-1157.1976.tb03394.x. [DOI] [PubMed] [Google Scholar]
- Toseland P. A., Grove J., Berry D. J. An isothermal GLC determination of the plasma levels of carbamazepine, diphenylhydantoin, phenobarbitone and primidone. Clin Chim Acta. 1972 May;38(2):321–328. doi: 10.1016/0009-8981(72)90122-2. [DOI] [PubMed] [Google Scholar]