Changes in antiepileptic drug prescribing patterns in large institutions: preliminary results of a five-year experience.

Routine antiepileptic prescriptions were analyzed for stable cohorts from two large, state-run, Accreditation Council-certified ICFs/MR for the time period October 1, 1987, to April 1, 1992. Results indicated marked decrease in numbers of individuals receiving (a) more than two antiepileptic drugs concurrently and (b) barbiturates. Retrospective analyses revealed that (a) over 90% of a group undergoing barbiturate taper maintained the same or improved seizure control and (b) some adults undergoing barbiturate tapers improved in target behaviors. Findings indicate the feasibility of changing antiepileptic regimens utilizing individual case evaluation and treatment and suggest the importance of considering possible psychological and behavioral disturbances associated with barbiturate therapy for adults and children.