Screening of the epileptic patient--is it worth the trouble?

More research needs to be devoted to prediction of who will develop toxic reactions. Studies such as those noting the association of valproate toxicity with young age (especially under two years) and polytherapy may reduce the number of patients with valproate liver failure by limiting the use of the drug in this higher risk group. Caution in using phenytoin in patients undergoing radiotherapy may decrease some of the severe exfoliative dermatitis problems induced by phenytoin. It is probable that some patients will continue to suffer severe adverse effects from anticonvulsants regardless of the number of contraindications that are proven. However, routine blood and urine screening does not appear at all likely to prevent these disasters.