[Phenomenon of "paradoxical poisoning" during antiepileptic therapy]

The article deals with a serious complication of antiepileptic treatment, namely, an increase in the frequency of epileptic attacks as a result of drug overdosage. The author considers the causes of this phenomenon. The most common of these causes include malpractice of the dosage build-up in the absence of the clinical effect, polytherapy--not infrequently with drugs of the same chemical group, and insufficient attention to the potentiating drug interaction. Of particular importance is the phenomenon of "paradoxical intoxication" consisting in an increase in the frequency of epileptic attacks without any other evident signs of drug poisoning when the blood concentrations of the drug exceed the therapeutic level. The author emphasizes the importance of the early detection of electroencephalographic and clinical initial manifestations of drug poisoning the necessity to monitor the plasma concentrations of the drug and the advantages of monotherapy.