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A controlled study with taltrimide and sodium valproate: valproate effective in partial epilepsy
M Iivanainen1, O Waltimo, O Tokola
1Department of Neurology, University of Helsinki, Finland.
Acta Neurologica Scandinavica
|August 1, 1990
Summary
Valproate significantly reduced seizure frequency in partial epilepsy patients. Taltrimide showed no significant benefit for partial or generalized epilepsy and was associated with adverse events.
Area of Science:
- Neurology
- Clinical Pharmacology
Background:
- Intractable epilepsy requires effective add-on therapies.
- Carbamazepine monotherapy is common, but breakthrough seizures occur.
- Investigating novel antiepileptic drugs like taltrimide is crucial.
Purpose of the Study:
- To compare the efficacy and tolerability of taltrimide versus valproate as add-on therapy in patients with intractable epilepsy on carbamazepine monotherapy.
- To assess the impact of taltrimide and valproate on seizure frequency in partial and primary generalized epilepsy.
Main Methods:
- A randomized, placebo-controlled, cross-over trial involving 17 patients with intractable epilepsy on carbamazepine monotherapy.
- Patients received taltrimide (400 mg/day), valproate (1000 mg/day), or placebo for 3-month periods.
- Serum carbamazepine levels were monitored to ensure they remained within the therapeutic range.
Main Results:
- Valproate demonstrated a statistically significant 27% reduction in seizure frequency in patients with partial epilepsy compared to placebo (p<0.05).
- Taltrimide did not show a significant reduction in seizure frequency for either partial or primary generalized epilepsy.
- In primary generalized epilepsy, both taltrimide and valproate showed reductions in seizure frequency, but these were not statistically significant compared to placebo.
- Adverse events reported with taltrimide included headache and, in one case, hypersensitivity reaction leading to treatment discontinuation.
Conclusions:
- Valproate is an effective add-on therapy for partial epilepsy in patients already on carbamazepine.
- Taltrimide did not prove effective as an add-on therapy in this study population and exhibited a less favorable safety profile.
- Further research may be needed to explore taltrimide's potential in specific epilepsy subtypes or at different dosages, but current evidence suggests limited utility.