Abstracts

Felbamate (FBM) is an antiepileptic drug with proven efficacy in the treatment of partial and generalized seizures. Idiosyncratic aplastic anemia and hepatoxicity have significantly limited its use. The aim of this study was to describe the clinical characteristics and to evaluate changes in weight, hematological parameters and liver function in long-term FBM users. During 1991, a computerized prospective database of all patients attending MINCEP[reg] Epilepsy Care (Minneapolis, MN) was established, and informed consent for use of clinical information was obtained from each patient. This database was initiated for an NIH funded study of SUDEP. Age, gender, epilepsy syndrome, and antiepileptic drugs used for each clinic visit were prospectively recorded. This database was utilized to identify all patients taking FBM at the time of this study. Weight, WBC, platelet, lymphocyte, granulocyte counts and AST were recorded for each patient at three time intervals: 1) prior to starting FBM; 2) one year after initiating FBM; and 3) most recent data (Table 1). Data was obtained through chart review. Repeated measures ANOVA was used for statistical analysis. One hundred eleven patients were identified as being current FBM users. At the time of the writing of this abstract, data has been analyzed on 39 (35%) patients (15 male/24 female, average age 32.5 years old). Patients were on FBM an average of 83.2 months (range 1.4-215.4) totaling 270.4 person years of follow-up. Patient[rsquo]s epilepsy syndrome included: 28 (72%) localization related; 9 (23%) symptomatic generalized; 2 (5%) primary generalized. Twelve (31%) were developmentally delayed. Etiologies included: 21 (54%) unknown; 6 (15%) infection; 4 (10%) vascular; 8 (21%) other. Ten (26%) patients had a history of hypersensitivity reaction; 1 (3%) patient had systemic lupus erythematosous. Differences across time for weight, hematological parameters and AST were not significant. [table1] In this selected population of long-term FBM users, weight, liver function and hematological parameters appear to remain stable. Although this study does not identify predictive variables for the development of hepatotoxicity or aplastic anemia, the data supports the relative safety of the long-term use of FBM in selected patients. (Supported by MINCEP[reg] Epilepsy Care)