Effects of rationalizing drug treatment of patients with epilepsy and mental retardation

Eighty patients with epilepsy and mental retardation were observed for a mean period of 12.5 months to assess the effects of 'rationalisation' of their drug treatment on both epilepsy and behaviour. Anticonvulsant drugs were modified to provide the best seizure control with the lowest toxicity, and psychotropic drugs were also monitored and modified if necessary to obtain the best results. At the end of the follow-up period the number of anti-epileptic drugs had fallen from 1.84 to 1.05 per patient. On admission to the study 47 patients were being treated with 85 psychotropic drugs: at the end of the follow-up 44 patients were taking 63 drugs. Seizures were significantly reduced in 16 of 39 patients with unsatisfactory control on admission to the study. Among 41 patients with initial satisfactory control, only 16 had relapse of seizures. Behaviour did not change significantly.