Clinical experience with topiramate dosing and serum levels in patients with epilepsy

Zanotta, Nicoletta; Raggi, Maria Elisabetta; Radice, Lucia; Degrate, Alessandro; Bresolin, Nereo; Zucca, Claudio

doi:10.1016/j.seizure.2005.11.003

Cited by 14 publications

(5 citation statements)

References 37 publications

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“…Interestingly, the effect of topiramate on kainate receptors appears to be GluK1 dependent, as the drug had no effect on in vitro preparations of GluK2 (former GluR6) kainate receptors (51). A partial action of topiramate has been also observed on AMPA receptors; however, in agreement with the current study, topiramate's action on this receptor had lower efficacy, while the blockade of kainate-evoked currents occurs at concentrations within the free serum levels of this anticonvulsant in patients (28,29,52).…”

Section: Discussionsupporting

confidence: 90%

Topiramate in the treatment of migraine: A kainate (glutamate) receptor antagonist within the trigeminothalamic pathway

Andreou¹,

Goadsby²

2011

Cephalalgia

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Section: Discussionsupporting

confidence: 90%

Topiramate in the treatment of migraine: A kainate (glutamate) receptor antagonist within the trigeminothalamic pathway

Andreou¹,

Goadsby²

2011

Cephalalgia

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“…Four patients became seizure-free, all with TPM dosages lower than the mean. Eleven patients had at least 50% seizure reduction [72].…”

Section: Refractory Primary Generalized Tonic-clonic Seizures In Adulmentioning

confidence: 99%

Topiramate: Its Pharmacological Properties and Therapeutic Efficacy in Epilepsy

Latini¹,

Verrotti²,

Manco³

et al. 2008

MRMC

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Since 1990 eight new antiepileptic drugs (AEDs) have been developed. Among these new drugs, Topiramate (TPM) is one of the latest AEDs available for treating drug resistant partial epilepsy both in adults and in children. The mechanisms underlying TPM antiepileptic activity are still incompletely understood. However, TPM, a sulfamate-substituted derivative of the naturally occurring monosaccharide D-fructose, has a different structure from other known AEDs. The antiepileptic activity of TPM in animal models of partial and generalized tonic-clonic seizures has been shown to be more effective as compared to other AEDs. Proposed mechanisms of action include reduction of epileptiform discharges through a voltage-dependent block of Na(+) channels, enhancement of the activity of gamma-aminobutyrate at some subtypes of gamma-aminobutyrate receptors, and antagonism of non- N-methyl-D-aspartate (NMDA) glutamate receptors. The pharmacokinetic profile of TPM, which is characterized by its rapid and almost complete absorption after oral administration, linear pharmacokinetics, minimal protein binding and predominantly renal excretion, makes the drug a good option for the treatment. TPM was found to be effective and well tolerated in many studies conducted in adults and pediatric patients suffering from epilepsy. This review, summarising the main studies in this field, provides an overview of the current knowledge about the relevant pharmacological and clinical information on the efficacy and tolerability of TPM.

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“…[255] Two studies reported no relationship between serum topiramate concentrations and adverse effects in children and adults. [293,294] 9. Vigabatrin…”

Section: Dose-related Effectsmentioning

confidence: 99%

The Safety and Tolerability of Newer Antiepileptic Drugs in Children and Adolescents

Sarco

Bourgeois

2010

CNS Drugs

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The newer antiepileptic drugs (AEDs) provide more therapeutic options and overall improved safety and tolerability for patients. To provide the best care, physicians must be familiar with the latest tolerability and safety data. This is particularly true in children, given there are relatively fewer studies examining the effects of AEDs in children compared with adults. Since we now have significant paediatric literature on each of these agents, we provide a comprehensive and current literature review of the newer AEDs, focusing on safety and tolerability data in children and adolescents. Because the safety profiles in children differ from those in adults, familiarity with this literature is important for child neurologists and other paediatric caregivers. We have organized the data by organ system for each AED for easier reference.

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Clinical experience with topiramate dosing and serum levels in patients with epilepsy

Abstract: We could not detect a direct relationship between high TPM SL and efficacy neither between high TPM SL and tolerability. However, the data we collected seem to favour the hypothesis that high TPM dosage and SL might be associated to a greater probability to reduce seizure severity.

Cited by 14 publications

References 37 publications

Topiramate in the treatment of migraine: A kainate (glutamate) receptor antagonist within the trigeminothalamic pathway

Topiramate in the treatment of migraine: A kainate (glutamate) receptor antagonist within the trigeminothalamic pathway

Topiramate: Its Pharmacological Properties and Therapeutic Efficacy in Epilepsy

The Safety and Tolerability of Newer Antiepileptic Drugs in Children and Adolescents

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