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Topiramate in the Long‐Term Management of Refractory Epilepsy
Author(s) -
AbouKhalil Bassel
Publication year - 2000
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.1528-1157.2000.tb02176.x
Subject(s) - topiramate , dose , adverse effect , medicine , epilepsy , refractory (planetary science) , anesthesia , anticonvulsant , partial seizures , surgery , psychiatry , physics , astrobiology
Summary: Purpose : A total of 292 adult patients (mean age, 33 years) with partial and/or generalized seizures previously resistant to antiepileptic drug (AED) therapy (median baseline seizure rate, 12 seizures/month) were treated with open‐label topiramate (TPM) in dosages of 100–1,600 mg/day. Methods : The mean duration of TPM treatment was 413 days (range, 84–804 days), and the mean TPM dosage was 503 mg/day (range, 100–1,600 mg/day; median TPM dosage, 300 mg/day). Seizure reduction was calculated from seizure counts during the last 3 months and last 6 months of TPM therapy compared with baseline. Results : Overall, >50% of patients achieved ges;50% seizure reduction. More important, 11 % of patients were seizure‐free for ges;3 months at the last visit; 10% of patients were seizure free for ges;6 months at the last visit. This robust therapeutic response was consistent for patients receiving TPM dosages >400 and <400 mg/day. The most commonly reported adverse events were related to the central nervous system. Over the 2·2‐year treatment period, 19% of patients discontinued TPM therapy because of inadequate seizure control; 32% discontinued because of adverse events. Findings from this study show that TPM is a useful agent for long‐term seizure control, with some patients becoming seizure free for extended periods despite failing previous AED therapy.