Topiramate or valproate in patients with juvenile myoclonic epilepsy: a randomized open-label comparison.

Abstract

Few randomized, controlled trials evaluating antiepileptic drug (AED) efficacy and tolerability have focused solely on patients with juvenile myoclonic epilepsy (JME). We conducted a pilot, randomized controlled trial comparing topiramate (N=19) and valproate (N=9) in adolescents/adults with JME to evaluate clinical response when these broad-spectrum agents are titrated to optimal effect. Rating scales were used to systematically assess tolerability. Among patients completing 26 weeks of treatment, 8 of 12 (67%) in the topiramate group and 4 of 7 (57%) in the valproate group were seizure-free during the 12-week maintenance period. Median daily dose was 250mg topiramate or 750mg valproate. Two (11%) topiramate-treated patients and one (11%) valproate-treated patient discontinued due to adverse events. Systemic toxicity scores, but not neurotoxicity scores, differed substantially between the two groups; greater systemic toxicity was associated with valproate. Our preliminary findings that topiramate may be an effective, well-tolerated alternative to valproate warrant validation in a double-blind trial.

• Authors: Paul M Levisohn, Katherine D Holland
• Journal: Epilepsy & behavior : E&B (Epilepsy Behav) Vol. 10 Issue 4 Pg. 547-52 (Jun 2007) ISSN: 1525-5050 [Print] United States
• PMID: 17482520 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anticonvulsants
• Topiramate
• Fructose
• Valproic Acid

Topics

• Adolescent
• Adult
• Aged
• Anticonvulsants (adverse effects, therapeutic use)
• Child
• Double-Blind Method
• Female
• Fructose (adverse effects, analogs & derivatives, therapeutic use)
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Myoclonic Epilepsy, Juvenile (drug therapy)
• Neurotoxicity Syndromes (epidemiology)
• Pilot Projects
• Seizures (epidemiology, prevention & control)
• Tomography, X-Ray Computed
• Topiramate
• Valproic Acid (adverse effects, therapeutic use)