Epilepsy outcomes in elderly treated with topiramate

Objectives –  To explore effectiveness, tolerability and quality of life in elderly patients with epilepsy treated with topiramate. Methods –  One year, open‐label, flexible‐dosing clinical trial. Results –  One hundred and seven patients (mean age 69 years, 53% men) were studied during 273 ± 141 days. The average final dose in monotherapy was 98 mg/day vs 153 mg/day in adjunctive treatment. Mean monthly cumulative seizure frequency decreased from 3.7 ± 15 to 1.6 ± 7.7 ( n  = 101, P  < 0.0001), 78% of patients with seizures at baseline ( n  = 102) achieved at least 50% reduction in seizure frequency, 44% were seizure‐free throughout the trial. Total scores on the quality of life in epilepsy inventory (QOLIE‐31) improved from 57 ± 17 to 68 ± 18 ( n  = 64, P  < 0.0001). The most frequently reported adverse events included convulsions, dizziness and tiredness. Conclusions –  Elderly patients treated with topiramate showed marked reductions in seizures, good tolerability and significant improvements in several aspects of quality of life.