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High dose gabapentin in refractory partial epilepsy: clinical observations in 50 patients
E A Wilson1, G J Sills, G Forrest
1University Department of Medicine and Therapeutics, Western Infirmary, Glasgow, UK.
Epilepsy Research
|February 26, 1998
Summary
This study found that high doses of gabapentin (GBP) can effectively reduce seizures in patients with refractory partial epilepsy. Some patients achieved seizure freedom with GBP doses up to 6000 mg daily.
Area of Science:
- Neurology
- Pharmacology
Background:
- Refractory partial seizures pose a significant challenge in epilepsy management.
- Adjuvant antiepileptic drug therapy is often necessary for patients with uncontrolled epilepsy.
Observation:
- A prospective, observational study evaluated the efficacy and tolerability of high-dose adjuvant gabapentin (GBP) in 50 patients with refractory partial seizures.
- Patients received escalating daily doses of GBP, with seizure frequency monitored against a 3-month baseline.
Findings:
- Overall, 24 out of 50 patients (48%) achieved a 50% or greater reduction in seizure frequency.
- Fifteen patients responded to GBP doses of 2400 mg or less, with three becoming seizure-free.
- Nine patients responded to higher doses (up to 6000 mg daily), with two achieving seizure freedom. Mean circulating GBP concentrations increased with dose, suggesting non-saturable absorption.
Implications:
- High-dose gabapentin may be a viable treatment option for patients with refractory partial epilepsy who do not respond to standard dosages.
- Further research is warranted to confirm these findings and establish optimal dosing strategies for high-dose GBP therapy.