| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Arkansas Epilepsy Program (Dr. Biton), Little Rock, AR; Epi-Care Center (Dr. Montouris), Memphis, TN; The Minnesota Epilepsy Group (Dr. Ritter), St. Paul, MN; Children’s Hospital (Dr. Riviello), Boston, MA; The Corporate Office Science and Technology, Johnson & Johnson (Dr. Reife), New Brunswick, NJ; and the R.W. Johnson Pharmaceutical Research Institute (Drs. Lim and Pledger), Raritan, NJ.
Address correspondence and reprint requests to Dr. Victor Biton, Arkansas Epilepsy Program, #1 Lile Court, Suite 100, Little Rock, AR 72205; e-mail: vbiton{at}worldnet.att.net
Background and
OBJECTIVE: Topiramate is effective as adjunctive treatment of partial-onset seizures in adults. The efficacy and safety of topiramate as adjunctive therapy for the treatment of primary generalized tonic-clonic (PGTC) seizures were investigated in a randomized, double-blind, placebo-controlled study.
METHODS: Eighty patients, 3 to 59 years old, who experienced three or more PGTC seizures during an 8-week baseline phase were randomly assigned to treatment with either topiramate (n = 39) or placebo (n = 41). Topiramate was titrated to target doses of approximately 6 mg/kg/day over 8 weeks and maintained for another 12 weeks.
RESULTS: The median percentage reduction from baseline in PGTC seizure rate was 56.7% for topiramate patients and 9.0% for placebo patients (p = 0.019). The proportion of patients with 50% or higher reduction in PGTC seizure rate was 22/39 (56%) and 8/40 (20%) for the topiramate and placebo groups, respectively (p = 0.001). The median percentage reduction in the rate of all generalized seizures was 42.1% for topiramate patients and 0.9% for placebo patients (p = 0.003). The proportions of patients with 50% or higher reductions in generalized seizure rate were 18/39 (46%) and 7/41 (17%) for the topiramate and placebo groups, respectively (p = 0.003). The most common adverse events were somnolence, fatigue, weight loss, difficulty with memory, and nervousness. Treatment-limiting adverse events occurred in one patient in the topiramate group (anorexia and weight loss) and one in the placebo group (granulocytopenia and thrombocytopenia).
CONCLUSION: Topiramate is well-tolerated and effective for the adjunctive treatment of PGTC seizures.
This article has been cited by other articles:
|
|
 |
|
  B. F.D. Bourgeois Broader is better: The ranks of broad-spectrum antiepileptic drugs are growing Neurology, October 30, 2007; 69(18): 1734 - 1736. [Full Text] [PDF]
|
|
|
|
|
|
S. F. Berkovic, R. C. Knowlton, R. F. Leroy, J. Schiemann, U. Falter, and On behalf of the Levetiracetam N01057 Study Group Placebo-controlled study of levetiracetam in idiopathic generalized epilepsy Neurology, October 30, 2007; 69(18): 1751 - 1760. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. A. Glauser, D. J. Dlugos, W. E. Dodson, A. Grinspan, S. Wang, S.-C. Wu, and and the EPMN-106/INT-28 Investigators Topiramate Monotherapy in Newly Diagnosed Epilepsy in Children and Adolescents J Child Neurol, June 1, 2007; 22(6): 693 - 699. [Abstract] [PDF]
|
|
|
|
 |
|
 E. Trevathan, S. P. Kerls, A. E. Hammer, A. Vuong, and J. A. Messenheimer Lamotrigine Adjunctive Therapy Among Children and Adolescents With Primary Generalized Tonic-Clonic Seizures Pediatrics, August 1, 2006; 118(2): e371 - e378. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. D. Sheth and B. E. Gidal Topical Review: Optimizing Epilepsy Management in Teenagers J Child Neurol, April 1, 2006; 21(4): 273 - 279. [Abstract] [PDF]
|
|
|
|
|
|
V. Biton, J. C. Sackellares, A. Vuong, A. E. Hammer, P. S. Barrett, and J. A. Messenheimer Double-blind, placebo-controlled study of lamotrigine in primary generalized tonic-clonic seizures Neurology, December 13, 2005; 65(11): 1737 - 1743. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Biton, B. F. D. Bourgeois, and for the YTC/YTCE Study Investigators Topiramate in Patients With Juvenile Myoclonic Epilepsy Arch Neurol, November 1, 2005; 62(11): 1705 - 1708. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Hawkins, D. Epstein, M. Drummond, J. Wilby, A. Kainth, D. Chadwick, and M. Sculpher Assessing the Cost-Effectiveness of New Pharmaceuticals in Epilepsy in Adults: The Results of a Probabilistic Decision Model Med Decis Making, September 1, 2005; 25(5): 493 - 510. [Abstract] [PDF]
|
|
|
|
|
|
M. C. Salinsky, D. Storzbach, D. C. Spencer, B. S. Oken, T. Landry, and C. B. Dodrill Effects of topiramate and gabapentin on cognitive abilities in healthy volunteers Neurology, March 8, 2005; 64(5): 792 - 798. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. C. Salinsky and D. Storzbach The Portland Neurotoxicity Scale: Validation of a Brief Self-Report Measure of Antiepileptic-Drug-Related Neurotoxicity Assessment, March 1, 2005; 12(1): 107 - 117. [Abstract] [PDF]
|
|
|
|
|
|
R. G. Holloway, J. A. French, A. Kanner, G. Gronseth, G. L. Krauss, J. A. French, C. P. Panayiotopoulos, S. R. Benbadis, A. Covanis, O. Dulac, et al. Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new onset epilepsy: Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society Neurology, January 11, 2005; 64(1): 172 - 174. [Full Text] [PDF]
|
|
|
|
 |
|
 S Beyenburg, J Bauer, and M Reuber New drugs for the treatment of epilepsy: a practical approach Postgrad. Med. J., October 1, 2004; 80(948): 581 - 587. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. French, A. M. Kanner, J. Bautista, B. Abou-Khalil, T. Browne, C. L. Harden, W. H. Theodore, C. Bazil, J. Stern, S. C. Schachter, et al. Efficacy and tolerability of the new antiepileptic drugs II: Treatment of refractory epilepsy: Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society Neurology, April 27, 2004; 62(8): 1261 - 1273. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. LaRoche and S. L. Helmers The New Antiepileptic Drugs: Scientific Review JAMA, February 4, 2004; 291(5): 605 - 614. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. LaRoche and S. L. Helmers The New Antiepileptic Drugs: Clinical Applications JAMA, February 4, 2004; 291(5): 615 - 620. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. W. Wheless, W. Neto, and S. Wang Topiramate, Carbamazepine, and Valproate Monotherapy: Double-Blind Comparison in Children With Newly Diagnosed Epilepsy J Child Neurol, February 1, 2004; 19(2): 135 - 141. [Abstract] [PDF]
|
|
|
|
 |
|
 M. A. Rigoulot, E. Koning, A. Ferrandon, and A. Nehlig Neuroprotective Properties of Topiramate in the Lithium-Pilocarpine Model of Epilepsy J. Pharmacol. Exp. Ther., February 1, 2004; 308(2): 787 - 795. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Nicolson, R E Appleton, D W Chadwick, and D F Smith The relationship between treatment with valproate, lamotrigine, and topiramate and the prognosis of the idiopathic generalised epilepsies J. Neurol. Neurosurg. Psychiatry, January 1, 2004; 75(1): 75 - 79. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. K. Nguyen and S. S. Spencer Recent Advances in the Treatment of Epilepsy Arch Neurol, July 1, 2003; 60(7): 929 - 935. [Full Text] [PDF]
|
|
|
|
|
|
M. Mula, M. R. Trimble, P. Thompson, and J. W.A.S. Sander Topiramate and word-finding difficulties in patients with epilepsy Neurology, April 8, 2003; 60(7): 1104 - 1107. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Biton, P. Levisohn, S. Hoyler, A. Vuong, and A. E. Hammer Lamotrigine Versus Valproate Monotherapy--Associated Weight Change in Adolescents With Epilepsy: Results From a Post Hoc Analysis of a Randomized, Double-Blind Clinical Trial J Child Neurol, February 1, 2003; 18(2): 133 - 139. [Abstract] [PDF]
|
|
|
|
|
|
R Renganathan and N Delanty Juvenile myoclonic epilepsy: under-appreciated and under-diagnosed Postgrad. Med. J., February 1, 2003; 79(928): 78 - 80. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F.G. Gilliam, F. Veloso, M.A.M. Bomhof, S.K. Gazda, V. Biton, J.P. Ter Bruggen, W. Neto, C. Bailey, G. Pledger, and S.-C. Wu A dose-comparison trial of topiramate as monotherapy in recently diagnosed partial epilepsy Neurology, January 28, 2003; 60(2): 196 - 202. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Glauser Integrating clinical trial data into clinical practice Neurology, June 25, 2002; 58(12_suppl_7): S6 - S12. [Full Text]
|
|
|
|
 |
|
 J. C. Chappell and H. Cohen Frontiers in Neuropharmacotherapy Part I: Alzheimer's Disease and Epilepsy Journal of Pharmacy Practice, June 1, 2002; 15(3): 195 - 220. [Abstract] [PDF]
|
|
|
|
 |
|
 J. A. Noviasky, A. P. Porsteinsson, and Y. H. Lee Second Generation Anticonvulsant Medications: Their Use in Children The Journal of School Nursing, April 1, 2001; 17(2): 103 - 111. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Biton, W. Mirza, G. Montouris, A. Vuong, A.E. Hammer, and P.S. Barrett Weight change associated with valproate and lamotrigine monotherapy in patients with epilepsy Neurology, January 23, 2001; 56(2): 172 - 177. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. W. Wheless Use of Topiramate in Childhood Generalized Seizure Disorders J Child Neurol, December 1, 2000; 15(1_suppl): S7 - S13. [Abstract] [PDF]
|
|
|
|
|
|
P. M. Levisohn Safety and Tolerability of Topiramate in Children J Child Neurol, December 1, 2000; 15(1_suppl): S22 - S26. [Abstract] [PDF]
|
|
|
|
|
|
B. F.D. Bourgeois Pharmacokinetics and Pharmacodynamics of Topiramate J Child Neurol, December 1, 2000; 15(1_suppl): S27 - S30. [Abstract] [PDF]
|
|
|
|
|
|
D. N. Franz, T. A. Glauser, C. Tudor, and S. Williams Topiramate therapy of epilepsy associated with Angelman's syndrome Neurology, March 14, 2000; 54(5): 1185 - 1188. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
