Topiramate monotherapy in adults with newly diagnosed epilepsy

This 6-month open-label study evaluated the efficacy and safety of topiramate monotherapy for partial-onset or primarily generalized seizures in 22 adults with newly diagnosed epilepsy. The initial topiramate dose of 25 mg could be titrated to a maximum effective or maximum tolerated dose of 200 mg/d. Eighteen patients completed the study. The mean topiramate dose was 200 mg/d (range, 75-200 mg/d). Compared with baseline, monthly seizure frequency decreased 89% (median), with 17 patients (94%) achieving complete control. Five patients dropped out of the study. No changes in hematologic, renal, and hepatic function evaluations were noted, and only 1 patient experienced clinical signs significant enough to warrant discontinuation of treatment. In this small study, topiramate in doses ranging from 75 to 200 mg/d was effective and well tolerated as monotherapy in adults with newly diagnosed epilepsy.