Reduction of polypharmacy in epileptic patients

An attempt was made to reduce polypharmacy in 90 epileptic patients. All patients received their original drug regimen for at least six months and were followed up for a minimum of 16 months after reduction of polypharmacy. In 72 patients (80%), the average number of drugs administered was reduced from 2.75 to 1.49. In 39 of these (54%), a reduction was made to single drug therapy. Either no change or an improvement in seizure control was observed, and side effects decreased in many patients. In 18 patients (20%), medications could not be withdrawn. In nine of these, another drug was required for seizure control. In the remaining nine, more frequent seizures necessitated a return to the previous regimen. The critical variable predicting unsuccessful reduction of polypharmacy was the presence of multiple concurrent seizure types.