ABSTRACT
Ethosuximide and valproate are presently the first-line drugs for the treatment of absence and myoclonic-atonic seizures. In any event, they will continue to need an antiepileptic medication for control of tonic-clonic or partial seizures, as imipramine and clomipramine are ineffective against these types of seizures and may sometimes exacerbate them. Irritability, urinary retention, drowsiness, and hallucinations have been reported occasionally during imipramine therapy but subsided promptly when the medication was discontinued. A case report describing a dramatic reduction in seizure frequency in a hyperuricosuric child treated with allopurinol has led to several trials in nonhyperuricemic epileptic patients, some of whom also experienced improved seizure control. The most commonly reported adverse effects in epileptic patients receiving allopurinol have been nausea and vomiting, diarrhea, headaches, malaise, and insomnia. A toxic syndrome associated with hypersensitivity has been reported in patients with renal insufficiency.
