Topiramate observational studies

Stephen LJ, Sills GJ, Brodie MJ. Topiramate in refractory epilepsy a prospective observational study. Epilepsia 2000 41(8) 977-80. 

Observational studies In a prospective, long-term observational study of topiramate as initial monotherapy in 229 Chinese patients with newly diagnosed epilepsy the retention rate was 76% at 1 year and 47% at 6 years [278 ]. Causes that led to treatment failure were lack of efficacy (7.4%), adverse reactions (11%), and loss to follow-up (16%). Adverse reactions occurred in 129 patients (56%). The most common included memory impairment (13%), weight loss (8.7%), nausea (7.3%), speech difficulty (5.7%), and somnolence (4.8%). Seven patients (3.1%) developed renal calculi. Most of the adverse reactions occurred in the first 6 months of treatment, especially during the titration period. 

Hu Y, Lu Y, Yu W, Shen D, Xiao Z, Xi Z, Wang X. Long-term retention rate of topiramate as initial monotherapy in Chinese patients with newly diagnosed epilepsy a prospective, observational study. Epilepsy Res 2010 90(3) 278-84. 

Observational studies In a long-term, open, observational study, the long-term retention rate and adverse effects of carbamazepine ( = 105) were evaluated and compared with topiramate ( = 41) in infants and toddlers with epilepsy [72 ]. After 6 months, 73% of those who had been treated with topiramate and 63% of those who had been treated with carbamazepine were improved. Topiramate was withdrawn because of adverse effects in only one case (2.4%), whereas carbamazepine was withdrawn because of adverse effects in 6.7% of patients. 

Observational studies Topiramate has been retrospectively evaluated in 227 patients with symptomatic epilepsy, of whom 12 withdrew because of adverse effects [292 ]. The incidence of adverse effects was 36% and the most common were weight loss, memory impairment, paresthesia, headache, and dizziness, most were mild to moderate in intensity and transient. 

In a prospective, observational study of rapid oral initiation of topiramate in 19 multiply handicapped children with resistant epilepsy who were given a mean initial dose of... 

Observational studies In a study of topiramate for intractable childhood generalized epilepsy with epileptic spasms, adverse effects were observed in 13 of 33 patients and included somnolence, anorexia, and irritability. Seizure aggravation was observed in six patients [16(P]. 

A significant improvement in neuropsychological functions associated with the frontal lobe after withdrawal of topiramate in epilepsy patients was reported in an open controlled study (643). The results suggested that verbal fluency and working memory were very sensitive to topiramate. Improvement in this function was observed after withdrawal of topiramate but not in the control group. 

The factors associated with behavioral and cognitive abnormalities in children taking topiramate have been studied retrospectively (644). There were behavioral or cognitive abnormalities in 11 of 75 children at 2-4 months after the start of therapy. The mean dosage (4.6 mg/kg/ day) at which these abnormalities were observed was similar to the mean final dose (5.8 mg/kg/day) in children... 

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