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Drug‐resistant epilepsy and topiramate: Plasma concentration and frequency of epileptic seizures
Author(s) -
Marques Fabiana Angelo,
Albuquerque Nayara Cristina Perez de,
Campos Marília Silveira de Almeida,
FreitasLima Priscila,
Baldoni André Oliveira,
Alexandre Júnior Veriano,
Sakamoto Américo Ceiki,
Oliveira Anderson Rodrigo Moraes de,
Pereira Leonardo Régis Leira
Publication year - 2018
Publication title -
clinical and experimental pharmacology and physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 103
eISSN - 1440-1681
pISSN - 0305-1870
DOI - 10.1111/1440-1681.12923
Subject(s) - topiramate , epilepsy , medicine , carbamazepine , anticonvulsant , adverse effect , antiepileptic drug , therapeutic index , poisson regression , anesthesia , regimen , drug , pharmacokinetics , pharmacology , population , psychiatry , environmental health
Summary Topiramate ( TPM ) is a second‐generation antiepileptic drug ( AED ), acting on drug‐resistant epilepsy. The aim of the study was to evaluate the influence of the dose, use of other AED s on TPM plasma concentration ( C p ), and frequency of epileptic seizures. A cross‐sectional analytical study was developed with patients aged 18‐60 years, for diagnosis of drug‐resistant epilepsy, using TPM in monotherapy or associated with other AED s. The following variables were analyzed: age, frequency of epileptic seizures, pharmacotherapeutic regimen with its respective doses, adherence to medication treatment, and adverse events score. Thirty‐seven patients were included, 83.8% of the patients presented C p below the therapeutic range. Multiple linear regression estimated that the increase of 1.0 mg/kg/d promoted an increase of 0.68 μg/ mL in TPM C p , while the use of inducers predicted a reduction of 2.97 μg/ mL ( P < .001). Multiple Poisson regression predicts that an increase of 1.0 μg/ mL in TPM C p decreased the patient's chance of presenting seizures, and patients using AED inducers were about ten times more likely to present seizures than those who do not use ( P < .001). In addition, for patients using AED inducers with C p below the therapeutic range, the mean number of seizures per month was greater than those with C p within the therapeutic range. The prescribed dose and the use of AED inducers influence C p of TPM , likewise the low C p of first‐line AED s and of the adjuvant in the treatment, TPM , as well as low TPM dose seem to affect the control of epileptic seizures.