The effects of antiepileptic medications on the social skills of individuals with mental retardation.
Phenytoin may quietly erode social skills in adults with ID—flag any social slump for med review.
01Research in Context
What this study did
Matson et al. (2004) compared social skills in adults with intellectual disability who took one of three seizure drugs.
They matched each drug group to similar adults who took no seizure drug.
All adults lived in the same large residential center.
What they found
Adults on phenytoin scored lower on social skills than their matched peers.
Adults on carbamazepine or valproate looked the same as peers.
The drop was big enough to notice in daily care.
How this fits with other research
Kahng et al. (1999) saw valproate calm aggression in a case series. The new study shows valproate does not boost social skills. Different outcomes explain the clash.
Lancioni et al. (2000) found barbiturate withdrawal cut problem behavior 80%. Adding the new data, some seizure drugs help behavior, some hurt social life, some do nothing.
Allen et al. (2001) warned carbamazepine can lower blood sodium. L et al. now add that carbamazepine keeps social skills steady, giving a fuller safety picture.
Why it matters
If a client on phenytoin seems withdrawn, the drug could be the cause. Ask the nurse or doctor to review the med plan. Track social initiations for two weeks before and after any change to see if skills rebound.
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02At a glance
03Original abstract
Prevalence rates of epilepsy are much higher among persons with developmental disabilities compared to the general population. Anticonvulsant medication is the most common method of treating seizure disorders. Many of these antiepileptic medications (AEDs) are associated with various side effects, which may have detrimental effects on the social skills of those with developmental disabilities. The present study investigated the effects of AEDs on the social skills of individuals with mental retardation (MR) residing in an institutional facility. The social skills of 130 individuals were assessed by the Matson Evaluation of Social Skills for Individuals with sEvere Retardation (MESSIER). Sixty-five of these individuals were diagnosed with a seizure disorder and received only one AED at the time of this study. These individuals were taking one of three AEDs (carbamazepine, valproic acid, or phenytoin). Participants belonging to one of these three medication groups were matched with residents for age, gender, level of MR and race, who did not have seizures or receive AEDs. MESSIER scores of each medication group were compared to its respective control group. Those individuals receiving phenytoin presented less positive social skills than their matched counterparts in the phenytoin-control group.
Research in developmental disabilities, 2004 · doi:10.1016/j.ridd.2003.10.002