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Clinical Administration of New Antiepileptic Drugs: An Overview of Safety and Efficacy
Author(s) -
Chadwick David W.,
Marson Tony,
Kadir Zakaria
Publication year - 1996
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1996.tb06035.x
Subject(s) - tolerability , lamotrigine , zonisamide , topiramate , vigabatrin , medicine , tiagabine , randomized controlled trial , gabapentin , epilepsy , odds ratio , anticonvulsant , anesthesia , adverse effect , psychiatry , alternative medicine , pathology
Summary: Gabapentin, lamotrigine, tiagabine, topira‐mate, vigabatrin, and zonisamide are all administered as add‐on therapy for treatment of patients with refractory epilepsy. To date, no comparative randomized trials have been performed that could potentially allow an evidence‐based choice to be made between these antiepileptic drugs (AEDs). We report a series of meta‐analyses of placebo‐controlled, randomized add‐on trials in patients with partial epilepsy. Results of these meta‐analyses are compared, thus giving broad estimates of the comparative efficacy and tolerability of these AEDs. The efficacy out come is the odds ratio for the number of patients with a ≥50% reduction in seizure frequency. Reported side ef fects are also used as tolerability outcomes, and study withdrawal is used as a global outcome measure. Results are summarized as odds ratios with 95% confidence in tervals (CIs). When each outcome is compared among drugs, the 95% CIS overlap. Therefore, no conclusive ev idence of a difference in efficacy or tolerability between these AEDs was derived, even though the apparently most effective agent (topiramate) may be twice as effec tive as the apparently least effective agent (lamotrigine). Comparative randomized studies are needed to further evaluate these drugs.