Anticonvulsant Drugs to Gain Speech

By Sonja
Posted April 23, 2012

Dear Dr Baker. My son is seven yrs old with very limited speech. Have done biomed for three years now with little results. His EEG results have come back normal due to two mild seizures he has had over the past two months. Should I put him on anticonvulsant drugs in hope he will gain speech?

Response

Answered:  April 25, 2012 by Dr. Sidney Baker

Dear Sonja,

I like your question because it gives me a chance to expand on a simple ‘yes’ answer.  Every treatment, no matter how well based it is on medical consensus or scientific evidence is, for each individual person, a sort of an experiment.  It is not an experiment in the sense of a test of a general hypothesis.  It is instead a test to see if the treatment will work in one particular person under certain particular circumstances at one particular time.

Your question reminds us that the target of treatment is the individual, not the disease. That being the case, the answer to the question of whether any of several medications that are classified as anticonvulsants might have a beneficial effect on your son’s brain and help with speech can only be answered by trying it.  Like most such questions, the choices involved are driven by the risk, benefit, stakes and odds. How high do the odds need to be if the stakes are high, and the benefit turns out positive with little risk?

In the context of your question I think that your medical consultants may agree that it’s worth a shot, or two, or more just to check it out.  Mild seizures with a normal EEG tells us that the evidence that we bring to these decisions can, at times, be imperfect. The best answers come from asking the patient’s body to give an opinion in the form of a response to a brief trial of treatment.  There are now many drugs in the anticonvulsant category that may be used off label.  There are, moreover, other drugs and biomedical options with similar status.

 

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Comments

Can you name some of these anticonvulsants Drugs that may be used on the off label for our kids? I am also involved with biomedical treatment and have been for the last 7 yrs. for my son who is also non-verbal. I would like to take this info and bring it to my specialist for further discussion. Thank you

That's great you have done some BioMed for three years! Sadly, my opinion is, I don't think an anti seizure medicine is going to "give" your child speech. There are so many good BioMed options to try - perhaps there are additional BioMed options you could consider trying? For a list of what we tried, and what worked for us, feel free to visit http://www.brainfoodcookbook.com/other_useful_therapies.htm Good luck to you and your family!

My son is 2.5 year old. He is diagnosed to have mild PDD. Speaks only 2-3 words. His EEG shows some minor changes (no seizures till date). His doctor's advice is to start on anticonvulsant (carbamazepine). Will this help my child? Is it too early to start an anticonvulsant for him?

At the Autism Research Institutes conference in Newark, New Jersey a couple of weeks ago, I asked my neurologist friend Paul Hardy, MD a question close to yours. It related to a patient of mine with a normal EEG but behaviors that are episodic. What was the top of his list of anticonvulsants to simply try for a while to see what good might come of it? Carbamazepine (Tegratol®) was second on his list. The top was Neurontin® (gabapentin). As I am sure you understand “anticonvulsant” may mean that a drug has gone through all the research and clinical trials to qualify it as safe and effective for treating seizures. It doesn’t by any means indicate that anticonvulsants’ effects are limited to control of seizures. An EEG, moreover, only measures what the electrodes can “see” near the surface of the brain. I believe that much of the regulatory problems in the brain of children with problems in “the spectrum” are far from the cortex (outer “shell”) of the brain but still may be affected by anticonvulsants even if no seizures are actually involved. Years ago a book, A Remarkable Medicine Has Been Overlooked, described reports of the beneficial effects of the anticonvulsant, phenytoin (Dilantin®), on hundreds of conditions that had nothing to do with seizures. It went against the “pill for an ill” concept of contemporary medicine. The book didn’t suggest that phenytoin was the right treatment for each of the conditions cited in credible case reports. Despite the expenditure of more than 100 million dollars on the of financier Jack Dryfus to promote the idea, it pretty much bounced off the surface of a medical viewpoint cautious about “experimentation” with “off label” uses of drugs. Every treatment of every person is, however, an experiment. The good thing about drugs is that they are quick. It may take a few weeks to walk away and say that something didn’t work, but most drugs work right away. I am not a big fan of drugs except in emergencies or for the relief of pain and prefer to look at the two questions underlying biomedical approaches first. Balancing stakes, risk, cost, benefit and an understandable sense of urgency gives a respectable place to a therapeutic trial of low-risk medications such as your doctor has suggested. If users of Autism360 will be generous toward other users by fully entering treatments and their positive, negative and neutral effects we will soon have a helpful compendium to help answer questions like yours. Autism Research Institute’s data reflecting the experience of over 26,000 parents over recent decades (http://www.autism.com/index.php/treatment_ratings_asd) rates 7 anticonvulsants for their anti-seizure and behavioral effects. Tegretol® and Depakene® are the only two for which the ratio of good to bad behavior effects are greater than 1.0 in 1556 and1146 patients respectively. Depakene has the highest (4.6:1) good to bad ratio as an anticonvulsant in the 761 reports relating to seizures. SMB