Alternative single anticonvulsant drug therapy for refractory epilepsy

Abstract

Fifty‐nine patients with chronic generalized toniclonic or partial seizures refractory to the maximally tolerated daily dosage of single‐drup therapy with carbamazepine, phenytoin, phenobarbital, or primidone subsequently received single‐drug therapy with another one of these primary anticonvulsant drugs. Alternative single‐drug therapy resulted in complete seizure control or more than 75% seizure reduction for 18 patients (31%). Side effects disappeared in 16 patients (27%). Patients with a good therapeutic response often had epilepsy of recent onset. Alternative single‐drug therapy is beneficial for chronic refractory epilepsy and should be considered before a second drug is permanently added.