Practical aspects of the use of topiramate in patients with epilepsy

Practical recommendations for the treatment of patients with the new antiepileptic drug (AED) topiramate (TPM) were developed on the basis of review of the results of controlled and open studies of TPM reported to date and on postmarketing clinical experience with TPM at two specialized epilepsy clinics in the United Kingdom. Recommendations considered important for optimal utilization of TPM include dosage titration guidelines, options for managing side effects occurring early in treatment, advice concerning the withdrawal of concomitant AEDs, indications for discontinuation of TPM, and recognition of the need for adequate patient counseling.