Q: I am taking sodium phenytoin capsule (eptoin) since the past 30 years. Can I reduce or avoid taking the drug or I have to take it forever to avoid an epileptic attack?

A:The actual management of epilepsy depends on the age of onset, type of epilepsy, frequency and severity of attacks. Hence each individual has to be treated on merit. In general 60% of adults and 70% of children can be completely withdrawn from drug therapy. If there is no attack for 1-5 years, one should attempt to withdraw drugs by gradually reducing the dose over 2-3 months. If there is a recurrence of attack it usually happens with 3 months of withdrawal. As you know the name of the medicine is phenytoin sodium and it is sold under different brand names. Since the medicine is to be taken over prolonged periods, doctors should prescribe least expensive brands of a good quality manufacturer. The cost of 100 tablets of the brand being consumed by you is just over Rs. 120 while that of Epsolin (Cadila Healthcare) is nearly half: about Rs. 70.