Antiepileptic drug behavioral side effects in individuals with mental retardation and the use of behavioral measurement techniques.

Measurement methods from behavioral psychology were used to assess antiepileptic drug behavioral side effects in 5 individuals with mental retardation. When the suspected antiepileptic drug was altered, an 81% reduction of maladaptive behaviors occurred. Quality of life outcomes included successful community placement and termination of an aversive intervention procedure. Three cases demonstrated antiepileptic drug exacerbation of disruptive vocalizations, agitation, self-injurious behavior, and property destruction; 2 demonstrated improved aggression, but illustrated a common clinical problem. When seizure control must be maintained and a suspected antiepileptic drug cannot be reduced before a second antiepileptic drug with potential psychotropic properties is initiated, it was not possible to absolutely conclude that the first antiepileptic drug was responsible for the behavior problem. Overall, these measurement methods were instrumental in the systematic clinical evaluation of antiepileptic drug behavioral side effects in individuals unable to verbally communicate the presence of these side effects.