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Related Experiment Videos

Topiramate monotherapy for partial onset seizures

R C Sachdeo1, R A Reife, P Lim

  • 1University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick 08903-0019, USA.

Epilepsia
|March 1, 1997
PubMed
Summary

Topiramate (TPM) monotherapy at 1,000 mg/day effectively controlled partial onset seizures compared to 100 mg/day. Higher doses demonstrated superior efficacy and a favorable safety profile in patients with uncontrolled epilepsy.

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Area of Science:

  • Neurology
  • Clinical Pharmacology
  • Epilepsy Research

Background:

  • Partial onset seizures are a common form of epilepsy.
  • Existing antiepileptic drugs (AEDs) may not achieve adequate seizure control for all patients.
  • Topiramate (TPM) is an established AED with various mechanisms of action.

Purpose of the Study:

  • To evaluate the efficacy and safety of topiramate (TPM) as monotherapy for patients with uncontrolled partial onset seizures.
  • To compare two different dosages of TPM (100 mg/day vs. 1,000 mg/day) in a monotherapy setting.

Main Methods:

  • A double-blind, parallel-group trial involving 48 patients with at least eight partial onset seizures during baseline.
  • Patients received open-label TPM 100 mg/day before randomization to double-blind TPM 100 mg/day or 1,000 mg/day.

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  • The study endpoint was 112 study days, with exit criteria including seizure rate increase or occurrence of generalized tonic-clonic seizures.

    • Main Results:

    • Higher success frequency (p = 0.005) and longer time until exit (p = 0.002) were observed with TPM 1,000 mg/day compared to 100 mg/day.
    • TPM 1,000 mg/day achieved ≥50% seizure reduction in 46% of patients, versus 13% for 100 mg/day.
    • Adverse events were generally mild to moderate.

    Conclusions:

    • Topiramate monotherapy at 1,000 mg/day is effective for managing partial onset seizures, including those with secondary generalization.
    • The higher dose of TPM demonstrated a favorable safety profile and improved seizure control.
    • TPM 1,000 mg/day represents a viable monotherapy option for refractory partial onset seizures.