PMID: 2111768May 1, 1990Paper

Discontinuation of phenytoin, carbamazepine, and valproate in patients with active epilepsy

Epilepsia
J S DuncanM R Trimble

Abstract

The effects of discontinuing individual antiepileptic drugs (AEDs) in patients with active epilepsy who are receiving combination therapy have not been studied systematically. We report a double-blind, prospective study of discontinuation of phenytoin (PHT), carbamazepine (CBZ), and valproate (VPA) in 70 patients with chronic active epilepsy. Each drug discontinuation was randomized to one of two relatively fast rates of reduction, and a control group of 25 patients continued with stable therapy. Patients who had CBZ removed had a significant increase in seizures that was maintained for 4 weeks after the end of drug reduction, and 10 of these 23 patients had to restart therapy with CBZ. There was no significant change in seizure numbers in the other groups. Two patients discontinued from VPA had to restart the drug; none had to restart PHT. The optimal rates of reduction of CBZ remain uncertain. There was no evidence for a clinically or temporally distinct burst of "discontinuation seizures" in any group. Any marked increase in seizures always resolved on reintroduction of the discontinued drug.

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Citations

Apr 1, 1995·Pediatric Neurology·L S ChenO C Snead
Apr 1, 1992·Epilepsy Research·T W Rentmeester, J A Hulsman
May 29, 2000·Pathophysiology : the Official Journal of the International Society for Pathophysiology·M E WeinandD M Labiner
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Jun 17, 1998·Seizure : the Journal of the British Epilepsy Association·B E Caviedes, J L Herranz
Oct 9, 2001·Acta Neurologica Scandinavica·H StefanE Pauli
May 10, 2000·Psychiatry and Clinical Neurosciences·M Matsuura
Nov 1, 1992·Acta Neurologica Scandinavica·A H Bardy
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Apr 1, 1995·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·N Y LorenzoW H Theodore
Mar 3, 2011·Journal of Clinical Psychopharmacology·Chih-Sung LiangKuo-Tung Chiang
Dec 29, 2000·Therapeutic Drug Monitoring·J C DeToledoE A Garofalo
Feb 19, 2008·Epilepsy Research·Nabil J AzarBassel W Abou-Khalil
Jun 13, 2016·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Irma ConvertinoMarco Tuccori

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