EFFECTS OF DISCONTINUATION OF INDIVIDUAL ANTIEPILEPTIC DRUGS ON MOOD

Forty-four patients undergoing withdrawal of phenytoin, carbamazepine or sodium valproate and 21 patients on stable medication were assessed using standardised, objective ratings of mood, notably the Mood Adjective Checklist and the Middlesex Hospital Questionnaire. The study followed a prospective, double-blind, placebo-controlled design. Patients' mood was assessed before and after drug withdrawal with an additional assessment being made four weeks after the completion of withdrawal. The number of seizures, serum anticonvulsant levels and EEGs were assessed at the same time as the mood assessments. In addition, the potential influence of life events on mood was monitored. Anxiety, as measured by the Middlesex Hospital Questionnaire, increased on withdrawal of carbamazepine. This change was not related to seizure rate. Withdrawal of phenytoin or sodium valproate did not appear to have an impact on mood. Concomitant changes in serial EEGs are discussed in relation to the changes in mood.