Magazine article Clinical Psychiatry News

Newly Diagnosed Epilepsy Responds Well to Topiramate Monotherapy: Higher Dose More Effective

Magazine article Clinical Psychiatry News

Newly Diagnosed Epilepsy Responds Well to Topiramate Monotherapy: Higher Dose More Effective

Article excerpt

HONOLULU -- Topiramate mono-therapy proved effective in children and adolescents newly diagnosed with epilepsy, Dr. John M. Pellock reported at the annual meeting of the American Academy of Neurology.

The study involved 151 children and adolescents aged 6-15 years who were part of a larger study of 470 children, adolescents, and adults. They were randomized to receive either 400 mg/day or 50 mg/day of topiramate (Topamax), and were treated for 6-12 months.

Kaplan-Meier analysis showed a significant advantage for the higher dosage in terms of time to first seizure. The seizure-free rates at 6 and 12 months, respectively, were 90% and 85% in the 400 mg/day group, compared with 78% and 62% in the 50 mg/day group.

Dr. Pellock, of the Virginia Commonwealth University Health System (Richmond), explained that a placebo-controlled trial might have been appropriate had they been testing topiramate as an adjunctive therapy. But they regarded a placebo control as unethical in the context of monotherapy, which is why they chose to compare two topiramate doses.

Topiramate is currently approved as an adjunctive therapy for epilepsy in patients over 2 years of age. …

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