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Topiramate slow dose titration: improved efficacy and tolerability

Abla M Albsoul-Younes1, Hazem A Salem, Saleh F Ajlouni

  • 1Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.

Pediatric Neurology
|November 3, 2004
PubMed

Insights

Slowly increasing topiramate dosage improved seizure control in children with refractory epilepsy. This approach enhanced treatment efficacy and tolerability, with most patients experiencing significant seizure reduction and manageable side effects.

Area of Science:

  • Neurology
  • Pediatric Epilepsy
  • Pharmacology

Background:

  • Topiramate is an established antiepileptic drug.
  • Refractory epilepsy in children presents significant treatment challenges.
  • Optimizing drug titration is crucial for improving therapeutic outcomes.

Purpose of the Study:

  • To evaluate the efficacy and tolerability of a slow topiramate dose titration regimen.
  • To assess topiramate as an add-on therapy in pediatric refractory epilepsy.
  • To determine the impact of slow titration on seizure frequency and side effects.

Main Methods:

  • Prospective, open-label, single-center add-on study.
  • 22 children with refractory epilepsy participated.
  • Topiramate (0.5-2 mg/kg/day) was slowly titrated over 2-week intervals to 6-12 mg/kg/day.

Main Results:

  • Significant reduction in weekly seizure frequency from 23.1 to 3.5 (P < 0.001).
  • 86% of patients achieved >50% seizure reduction; 31% became seizure-free.
  • Mild to moderate side effects (somnolence, anorexia) were common; only 5% discontinued due to intolerance.

Conclusions:

  • Slow topiramate dose titration enhances efficacy in pediatric refractory epilepsy.
  • This titration strategy improves tolerability, reducing adverse events.
  • Slow titration is a viable option for optimizing add-on therapy in children with difficult-to-treat epilepsy.

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