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Max Bader, MD, MPH
Seattle

JAMA. 1978;240(22):2431.

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To the Editor.—

I concur with the general findings of King and Young (239:2674, 1978) related to prisoners and their seizure disorders. Based on my limited experience, the prevalence of prisoners receiving anticonvulsants in Seattle is undoubtedly equivalent to that in Illinois. However, two points must be recognized.

1. There is a tendency for prisoners to be overmedicated. Many prisoners who take anticonvulsants are probably not suffering from epilepsy. They continue to receive these drugs because no one has the inclination to reassess the need for them. In this day of frequent prisoner complaints about their medical care and common lawsuits related to "violations" of prisoners' rights, the jail physician is often subjected to abuse if he tries to readjust a prisoner's medications.
   
2. A high proportion (often more than half) of prisoners are alcoholics or addicts. It is my impression that most prisoners who take anticonvulsants are among this
   

Footnotes
Edited by John D. Archer, MD, Senior Editor.

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