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Treatment Considerations in Anticonvulsant Monotherapy
Authors:B. J. Wilder
Affiliation:Neurology Service, Veterans Administration Medical Center;Department of Neurology, University of Florida College of Medicine, Gainesville, Florida, U.S.A.
Abstract:Summary: The long-standing practice of polypharmacy in treating epilepsy is giving way to use of monotherapy. Monotherapy can improve seizure control as well as reduce the risk of serious idiosyncratic reactions, dose-related side effects, and complex drug interactions. Monotherapy also offers improved compliance and cost-effectiveness. The basis of monotherapy is accurate diagnosis and assessment of the patient's seizure type(s), followed by selection of a single appropriate anticonvulsant drug. Many patients currently treated with multiple anticonvulsants can be successfully converted to monotherapy with a carefully monitored program in which troublesome and redundant drugs are gradually withdrawn from the therapeutic regimen.
Keywords:Epilepsy—    Seizures—    Therapy—    Anticonvulsants—    Valproate—    Phenytoin—    Phenobarbital—    Drug-induced abnormalities—    Pharmacology—    Drug interactions
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