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[Topiramate--a new antiepileptic agents].
T Svendsen1, S I Johannessen, K O Nakken
1Statens senter for epilepsi, Sandvika.
Summary
Topiramate is an effective adjunctive therapy for refractory epilepsy, with nearly half of patients experiencing over 50% seizure reduction. However, side effects are common and may necessitate drug withdrawal.
Area of Science:
- Neurology
- Pharmacology
Background:
- Topiramate, an antiepileptic drug, approved in Norway in 1997 for partial seizures.
- Clinical trials suggest topiramate is a potent antiepileptic with favorable pharmacokinetics.
- Clinical experience with topiramate at the National Center for Epilepsy since 1990.
Purpose of the Study:
- To present clinical experience with topiramate as adjunctive therapy.
- To evaluate the efficacy and tolerability of topiramate in patients with epilepsy.
Main Methods:
- Retrospective assessment of 114 adult patients with intractable partial seizures.
- Topiramate used as add-on treatment with an average follow-up of 2.3 years.
Main Results:
- Four patients (3.5%) achieved seizure freedom.
- 56% of patients experienced over 50% reduction in seizure frequency.
- Adverse effects occurred in 72% of patients, leading to withdrawal in 47%.
Conclusions:
- Topiramate demonstrates efficacy as adjunctive therapy for refractory epilepsy.
- Common side effects include weight loss, fatigue, and cognitive issues.
- Mitigation strategies for side effects include low starting dose, slow escalation, and monotherapy.