The prescription sheets for all patients in a mental handicap hospital on one day in 1972 and on the same date in 1982 were examined to identify trends in anticonvulsant medication over a 10-year period. There was a reduction in size of the hospital population associated with fewer very young and milder handicapped persons. Prescription of anticonvulsants fell slightly during the decade under study with a dramatic fall in the use of phenobarbitone, and a parallel increase in the prescription of carbamazepine. Other changes included the use of sodium valproate in a significant minority of patients and the occasional use of clonazepam in 1982, while phenytoin remained a first-rank anticonvulsant throughout the period under review. The proportions of patients on polytherapy did not change over the 10-year period, though the contribution of phenobarbitone to the combined drug regimes was significantly reduced.
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Sheppard et al. (1987) studied this question.