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 Adjec tive Checklist and the Middlesex Hospital Questionnaire. The study fol lowed a prospective, double-blind, placebo-controlled design. Patients ' mood was assessed before and after drug withdrawal with an additiona l assessment being made four weeks after the completion of withdrawal. The number of seizures, serum anticonvulsant levels and EEGs were ass essed at the same time as the mood assessments. In addition, the poten tial influence of life events on mood was monitored. Anxiety, as measu red by the Middlesex Hospital Questionnaire, increased on withdrawal o f carbamazepine. This change was not related to seizure rate. Withdraw al of phenytoin or sodium valproate did not appear to have an impact o n mood. Concomitant changes in serial EEGs are discussed in relation t o the changes in mood.