Abstracts

Topiramate (TPM) is a broad-spectrum antiepileptic drug with multiple mechanisms of action. It was approved for use in the United States in 1996 as adjunctive therapy for adults and children 2 years and older,with either partial or primary generalized onset seizures. The purpose of this study was to review our clinical experience with TPM in a variety of epilepsy syndromes in an academic referral center.
We retrospectively analyzed the charts of 24 patients treated with TPM from Oct 1999 to Feb 2003. Topiramate was given at a dose of 25-50 mgs/day, up to maintenance dose of 400 mgs/day.Patients were followed with regards to efficacy, safety and adverse events. (AEs)
We identified 24 patients, ranging in age 18- 58 years , 14 females and 10 males treated with TPM for various epileptic syndromes including partial onset epilepsy (N=14) and primary generalized epilepsy (N=10).Patients were taking one to three AEDs at the time TPM was added .Five patients were able to convert to monotherapy.Twenty patients ( 70%),achieved [ge] 50 % reduction in seizure frequency, and three remained seizure free for the duration of the study.Seven patients experienced beneficial weight loss and one achieved headache control with the addition of TPM.Five, discontinued TPM, 1 due to lack of efficacy and 4 due to AEs.Adverse events included behavioral changes , lethargy , cognitive impairment, slurred speech and weight loss .
Our experience demonstrated efficacy and tolerability of TPM in patients with partial and generalized onset epilepsy. TPM can be used sucessfully as monotherapy. Patients with comorbid headache and obesity can benefit from its use.