Conversion from valproic acid onto topiramate in adolescents and adults with epilepsy

Schreiner, A.; Stollhoff, Kirsten; Ossig, W.; Unkelbach, S.; Lüer, W.; Bogdanow, Manuela; Schäuble, Barbara

doi:10.1111/j.1600-0404.2008.01130.x

Cited by 9 publications

(4 citation statements)

References 37 publications

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“…This left us with 13 main studies, which are described in Table 1 and discussed in the rest of this review. Schreiner et al reported an open-label, single arm, non-interventional study to explore the efficacy and tolerability of TPM, in patients moving from baseline monotherapy or combination therapy with valproic acid, because of inadequate seizure control and/or tolerability [54]. TPM was added initially to the existing AED regimen and based on the clinical judgment of the treating physician, a decision was made whether and when the existing antiepileptic scheme (particularly with valproate) could be withdrawn.…”

Section: Resultsmentioning

confidence: 99%

The Effect of Alterations in Consciousness on Quality of Life (QoL) in Epilepsy: Searching for Evidence

Charidimou

Selai

2011

Behavioural Neurology

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Abstract. The impact of epilepsy on Quality of Life (QoL) is well-documented. The ability of epileptic seizures to alter the conscious states of patients is also well established. Although there is much research on the QoL of people with epilepsy, few researchers have looked specifically at the effect of sudden, unanticipated alterations of consciousness on QoL. This lack of systematic studies of consciousness alterations and QoL in epilepsy limits our ability to shed light on this interrelation. In this article, with these limitations in mind, we focus on studies of newer AEDs. We review the evidence as to whether a significant reduction (typically more than 50%) in seizures that induce alterations of consciousness, as a result of switching to one of the newer AEDs, leads to improvements in QoL. We draw on this literature to speculate on the relationship between ictal consciousness alterations and poor QoL in epilepsy, to identify contributory and confounding factors and to highlight implications for future research. We suggest that an understanding of how factors associated with consciousness impairment affect QoL could help the treatment and management of these patients.

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Section: Resultsmentioning

confidence: 99%

The Effect of Alterations in Consciousness on Quality of Life (QoL) in Epilepsy: Searching for Evidence

Charidimou

Selai

2011

Behavioural Neurology

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“…On the other hand, mixed results have been reported on the role of daily dosage. While some studies did not find a direct relationship between weight reduction and TPM dosage [351,352], data from other studies support that the extent of the loss is directly related to final dose [325,353]. As for gender, some results that suggested a greatest BMI decrease in females [351] have not been confirmed in other studies that did not find differences between adult males and females [354].…”

Section: Efficacy and Tolerability Of Topiramate As Anti-obesity Drugmentioning

confidence: 97%

“…Several factors have been studied as predictors of weight loss related to TPM intake. Among them, the baseline BMI and the duration of treatment appears to be the most closely related, whereas the role of gender and daily dosage is uncertain [327,[351][352][353][354][355][356][357][358][359]. With regard to the duration of TPM treatment, the weight loss occurred most frequently during the first months of treatment (4 to 6 months) and continued for at least 1 year [335,[348][349][350].…”

Section: Efficacy and Tolerability Of Topiramate As Anti-obesity Drugmentioning

confidence: 99%

An Approach to Obesity as a Cardiometabolic Disease: Potential Implications for Clinical Practice

Sabán-Ruiz¹,

Fabregate-Fuente²,

Fabregate-Fuente³

et al. 2014

Anti-Obesity Drug Discovery and Development

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3Atta-ur-Rahman and M. Iqbal Choudhary (Eds) All rights reserved-Abstract: Obesity is a multifactorial disease that is currently developing a threatening tendency towards becoming the main cause of chronic disease in the world. Obesity can induce type 2 diabetes mellitus, dyslipidemia, cardiovascular disease and other chronic disorders with high social and health costs. Obesity was firstly described in 2000 as a cardiometabolic disease, even before Metabolic Syndrome, type 2 diabetes mellitus and coronary disease were considered as such. In this chapter we recover this approach to obesity, which has remained almost forgotten for the last decade. In obese subjects, adipokines and miokines interact to promote reticulum stress, insulin resistance, metabolic inflexibility and endothelial dysfunction. These pathological processes are amplified when hyperglycemia is present, leading to an increased risk for atherosclerosis. A number of potential implications for clinical practice are derived from the cardiometabolic state underlying obesity and its comorbidities. The first step in the therapeutic strategy against obesity should be the correct diagnosis of its causes and the promotion of lifestyle changes including physical exercise and a healthy diet. In the usual case of failing to achieve results, we can still resort to the pharmacological therapy. While awaiting the release of new drugs, topiramate, alone or combined with phentermine, has been proposed as a novel anti-obesity drug, showing relevant effects not only on weight loss but also on cardiometabolic alterations and biomarkers, even though new studies should clarify the mechanisms of these findings. Finally, our own experience with topiramate is described, focusing on its effects upon weight loss and inflammatory markers.

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“…A conversion algorithm similar but faster than the one used in the present study was used in a study of topiramate (TPM), another new AED, in which TPM was added onto VPA monotherapy at 25-mg/day increment once every 1-2 weeks [17]. Upon reaching a TPM dose of 50-200 mg/day, the VPA dose was decreased to 0 mg/day.…”

Section: Discussionmentioning

confidence: 99%

Appropriate conversion from valproate monotherapy to lamotrigine monotherapy in Japanese women with epilepsy

Yamamoto

Kubota

Murayama

et al. 2016

E&S

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Purpose: Exposur e to sodium valpr oate (VPA) dur ing pr egnancy may incr ease the r isk of fetal malformations and cognitive developmental deficits. We therefore assessed a clinically practical method to change treatment from VPA monotherapy to lamotrigine (LTG) monotherapy in Japanese women of childbearing potential whose seizures were controlled by VPA. Methods:In an open-label, single arm, multicenter study, we evaluated the reduction in VPA dose and change in seizure frequency from baseline when VPA monotherapy was switched to LTG monotherapy in female patients by the following protocol. (1) The LTG dose was increased up to 200 mg/day while the initial VPA dose was maintained. (2) The VPA dose was reduced to 0 mg/day while the LTG dose was maintained. (3) When VPA was removed, the LTG dose was simultaneously increased by up to 100 mg/day. (4) The LTG dose was further adjusted. Due to the risk of break-through seizures during adjustment of VPA and LTG doses, LTG trough serum concentration was measured for seizure control. Results: Of 33 patients enr olled, 20 completed the entir e pr otocol, with VPA r emoval in 19 patients. Thirteen patients were withdrawn from the study during LTG escalation, mainly due to LTG-related skin rash (n = 8) in the early stage of LTG initiation (10 days on average). Seizures were observed once in 2 patients during LTG monotherapy (7 and 13 weeks after VPA removal). Discussions: By paying car eful attention to the occur r ence of skin r ash or any sign of hypersensitivity at the beginning of LTG escalation, Japanese women receiving VPA monotherapy can be converted to LTG monotherapy.

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Conversion from valproic acid onto topiramate in adolescents and adults with epilepsy

Abstract: In patients with epilepsy not satisfactorily treated with VPA, conversion to TPM was associated with improved seizure control as well as improvement in several aspects of quality of life.

Cited by 9 publications

References 37 publications

The Effect of Alterations in Consciousness on Quality of Life (QoL) in Epilepsy: Searching for Evidence

The Effect of Alterations in Consciousness on Quality of Life (QoL) in Epilepsy: Searching for Evidence

An Approach to Obesity as a Cardiometabolic Disease: Potential Implications for Clinical Practice

Appropriate conversion from valproate monotherapy to lamotrigine monotherapy in Japanese women with epilepsy

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