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WHEN CAN ANTICONVULSANT THERAPY BE STOPPED?

Starting anticonvulsant therapy is rarely a controversial decision, but little is known about when it is appropriate to stop these drugs. These investigators discontinued anticonvulsants in 92 patients (adults and children) who had been seizure-free for two years, and found that 66 percent remained seizure-free during a mean follow- up of 35 months. The risk of relapse increased with the number of previous seizures and the number of drugs the patient had used previously to control the seizures. A high electroencephalographic class, a history of complex partial seizures, and treatment with sodium valproate were also predictors of relapse.

These findings should prove useful in identifying those patients for whom discontinuation of therapy is reasonable.

— THL

Published in Journal Watch General Medicine April 19, 1988

Citation(s):

Callaghan N; Garrett A; Goggin T. Withdrawal of anticonvulsant drugs in patients free of seizures for two years: a prospective study. N Engl J Med 1988 Apr 14 318 942-946.

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