Topiramate, carbamazepine and valproate monotherapy: double-blind comparison in newly diagnosed epilepsy.

Abstract

OBJECTIVES:

To compare topiramate (TPM) with investigator's choice of carbamazepine (CBZ) or valproate (VPA) for initial treatment in patients with newly diagnosed epilepsy.

MATERIAL AND METHODS:

In patients with epilepsy diagnosed within previous 3 months, investigators selected CBZ (600 mg/day) or VPA (1250 mg/day) as preferred therapy based on the patient's clinical presentation. Based on investigators' treatment choice, patients (n=613) were assigned to the CBZ or VPA treatment branch. Within each branch, patients were randomized to double-blind treatment with the traditional antiepileptic drugs (CBZ or VPA), TPM 100 mg/day, or TPM 200 mg/day. Patients continued double-blind treatment until exiting the study or until 6 months after last patient randomized.

RESULTS:

No statistically significant differences between fixed doses of TPM and CBZ or VPA were observed in efficacy measures: time to exit, time to first seizure, and the proportion of patients seizure-free during the last 6 months of treatment. TPM 100 mg/day was associated with the fewest discontinuations due to adverse events.

CONCLUSION:

In patients with newly diagnosed epilepsy, an initial target dose of TPM 100 mg/day is at least as effective as therapeutic doses of CBZ and VPA.

• Authors: M D Privitera, M J Brodie, R H Mattson, D W Chadwick, W Neto, S Wang, EPMN 105 Study Group
• Journal: Acta neurologica Scandinavica (Acta Neurol Scand) Vol. 107 Issue 3 Pg. 165-75 (Mar 2003) ISSN: 0001-6314 [Print] Denmark
• PMID: 12614309 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anticonvulsants
• Topiramate
• Fructose
• Carbamazepine
• Valproic Acid

Topics

• Administration, Oral
• Adolescent
• Adult
• Aged
• Anticonvulsants (administration & dosage, pharmacology)
• Carbamazepine (administration & dosage, pharmacology)
• Child
• Double-Blind Method
• Epilepsy (drug therapy, pathology)
• Female
• Fructose (administration & dosage, analogs & derivatives, pharmacology)
• Humans
• Male
• Middle Aged
• Seizures
• Topiramate
• Treatment Outcome
• Valproic Acid (administration & dosage, pharmacology)