The discovery of anti-epileptic drugs

The general history of epilepsy is well documented, there being detailed accounts from ancient times in Babylonia (Wilson et al., 1990), ancient India (Bharucha & Bharucha, 1989), and China (Lai & Lai, 1991), up until the end of the 19th century (Tempkin, 1971). But relatively little has been written about its medical treatment, (Melville, 1982). The subject of this article is the history of potassium bromide, phenobarbitone and phenytoin, how their use in epilepsy was discovered, and in particular the surprisingly large part played by chance, luck and serendipity, in their introduction to the pharmacopaeia. The advance in this field has been one of sudden leaps forward, followed by periods of apparent inactivity, until the next discovery emerged, a pattern repeated many times, since medical treatment of epilepsy began with potassium bromide in 1857, until the introduction of vigabatrin in 1990.