Assessment of topiramate’s efficacy and safety in epilepsy

Abstract

Objective:To study the significance of topiramate (TPM) addition on seizure control in treatment of epilepsy.Design:A prospective open label add-on trial of TPM addition in patients with epilepsy was done. The events of baseline phase of 12 weeks followed by titration and maintenance phases were recorded. Assessment of the number of seizure and emergent adverse effects was done by a monthly visit for each case.Main Outcome Measures:Reduction of more than 50% mean seizure frequency or response ratio of 0.33 was taken as the criteria for responders.Statistical Analysis:Normal Z-test for significance of differences between two proportions and Chi-square test for presence of association was applied and mean age, median duration, sex ratio, percentage prevalence were depicted.Results:Significant responses to TPM in both partial as well as generalized seizures were observed (Z = 6.66, P < 0.001 and Z = 4.185, P < 0.01). The effect was more pronounced in patients with partial seizures. However, the overall response was highly significant (Z = 7.839, P < 0.001). The best response was noted at the dose of 200–300 mg/day (Z = 6.708, P < 0.001). More than 35% cases of partial and generalized seizures reported more than 75% reduction levels. The drug was well tolerated in more than 65% cases for side effects on psychosis, giddiness, and anorexia. Mild side effects were seen only in about less than 35% cases.Conclusions:TPM was found as a significantly effective add-on anticonvulsant with some limitation or mild side effects.

Repurposing some older drugs that cross the blood–brain barrier and have potential anticancer activity to provide new treatment options for glioblastoma

“…TPM is a newer AED, with several mechanisms of action that might contribute to antiseizure effects . TPM, in addition to VPA, is classified as a category D drug in pregnancy, owing to an increased risk of fetal malformation .…”

Emerging roles of Na+/H+ exchangers in epilepsy and developmental brain disorders

“…Once a specific diagnosis of the cause of the seizure is determined, or if seizures become refractive to benzodiazepines, additional treatments targeting the GABAergic system may be applied, including GABA agonists, structural analogs, reuptake inhibitors, and inhibitors of GABA degrading enzymes (reviewed in Greenfield, 2013). Other classes of antiepileptic drugs (AEDs), such as channel blockers for Na + (Catterall, 2014), glutamate (Gupta et al, 2014; Steinhoff, 2015), and Ca 2+ (Goren and Onat, 2007), can be added to treatment regimens to successfully manage seizures. Levetiracetam is being increasingly used due to its low probability of pharmaco resistance and limited side effects.…”

Topiramate-induced maculopathy in IgG4-related disease

“… 1 The safety of topiramate in epilepsy was assessed in a prospective add-on trial of topiramate therapy to standard therapy in patients with epilepsy. 4 A total of 106 patients were studied. 4 The drug was well tolerated in >65% of cases for side effects such as psychosis, giddiness, and anorexia.…”

“… 4 A total of 106 patients were studied. 4 The drug was well tolerated in >65% of cases for side effects such as psychosis, giddiness, and anorexia. Mild side effects were seen in <35% of cases.…”