CLINICAL EXPERIENCE WITH TOPIRAMATE
Abstract number :
2.204
Submission category :
Year :
2002
Submission ID :
1894
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Manish B. Patel, Anita Gottipati, Michael Guido, Firas Beitinjaneh, Hasan Mousli, Mary R. Andriola. Neurology, Stony Brook University Epilepsy Management Program, State University Of New York at Stony Brook, Stony Brook, NY
RATIONALE: Topiramate (TPM) is a broad-spectrum antiepileptic drug (AED) with multiple mechanism of action. It is approved for use in the United States as adjunctive therapy in adults and children from age 2 with partial onset seizures or generalized onset seizures. The purpose of this study was to review our recent clinical experience with TPM in an academic referral center.
METHODS: A retrospective review of the patients treated with TPM at Stony Brook University Epilepsy Management Program was carried out between April 2000 and April 2002. There were 45 patients, 28 children (16 and under) and 17 adults. These patients were on one or two AEDs when TPM was started. Information was obtained in regard to efficacy, tolerability and duration of treatment.
RESULTS: There were 28 children (3months to 15years) with seizures classified as generalized onset (n=8) and partial in onset with secondary generalization (n=20). Associated disorders were present in the majority and included: mental retardation, attention deficit disorder, cerebral palsy, hydrocephalus and tic disorder. Efficacy of [gt]50% seizure reduction was found in 16 of 28 (57%) of these patients, three of whom are seizure free.
Seventeen adults (17-66 years) were treated. Efficacy of [gt]50% seizure reduction was found in 7 of 17 (41% ) of these patients. An additional two patients had no further seizures, but only experienced auras after TPM was started. Two patients remained seizure free for the duration of the study.
TPM was discontinued in 6 patients (13%) due to lack of efficacy and in three due to side effects. The most common reported side effect was lethargy (n=14, 31%). Mean duration of treatment with and without discontinuation of TMP as of April 2002 was 6.5 months. An obese patient experienced a 35 lb weight loss after being on TMP for 4 months. She continues to be seizure free on monotherapy. No patients experienced problems with renal calculi or glaucoma.
CONCLUSIONS: TPA provided improved seizure control in 41% of the adults and in a higher percentage of the children (57%). It was generally well tolerated with few patients discontinuing due to side effects. Weight loss was a desirable side effect for a few obese patients.