EVALUATION OF SEIZURE CONTROL AFTER PHENOBARBITAL WITHDRAWAL IN A MENTALLY-RETARDED DEVELOPMENTALLY DISABLED POPULATION

The withdrawal of phenobarbital (PB) from antiepileptic drug (AED) regimens of individuals can be safely and successfully completed without losing control of seizures. We analyzed the effect on seizure frequency and number of AEDs after PB was eliminated from the AED regimen. Thirty-four individuals with mental retardation (MR), developmental disabilities, and epilepsy residing at the St. Louis Developmental Disabilities Treatment Centers had PB withdrawn from their AED regimens. Charts were retrospectively reviewed for a 2 1/2-year period of monitoring seizure frequency and AED therapy. Seizure frequency was not significantly changed when a less-sedating AED regimen was used. The number of AEDs per individual was reduced from 2.03 to 1.47 immediately after the discontinuation of PB and 1.59 1 year later. Our study suggests that PB may be unnecessary for optimal seizure control and may be withdrawn safely from the AED regimen.