An audit of topiramate use in a general neurology clinic

The purpose of this study was to look at the efficacy and side effect profile of topiramate in a neurology unit. Using case notes, 94 patients who had been treated with topiramate were identified: 48 patients had taken part in clinical trials of topiramate, 46 received topiramate once licensed. Of t...

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Bibliographic Details
Published in:Seizure (London, England) England), 1998-06, Vol.7 (3), p.207-211
Main Author: Crawford, Pamela
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Ambulatory Care - statistics & numerical data
Anticonvulsants - adverse effects
audit
Child
Cognition - drug effects
Depression - chemically induced
epilepsy
Epilepsy - drug therapy
Female
Fructose - administration & dosage
Fructose - adverse effects
Fructose - analogs & derivatives
Hallucinations - chemically induced
Humans
Male
Medical Audit
Memory - drug effects
Middle Aged
Neurology - statistics & numerical data
Psychoses, Substance-Induced - etiology
psychosis
Retrospective Studies
topiramate
United Kingdom
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Summary:The purpose of this study was to look at the efficacy and side effect profile of topiramate in a neurology unit. Using case notes, 94 patients who had been treated with topiramate were identified: 48 patients had taken part in clinical trials of topiramate, 46 received topiramate once licensed. Of these patients 24% had a greater than 50% decrease in seizure frequency. Patients with primary generalized epilepsy ( n = 12) had a greater reduction in seizures compared with those with partial epilepsies ( n = 70) P > 0.03. There was a high incidence (41%) of side effects, particularly psychiatric problems, leading to withdrawal of therapy in 41% of patients. Seven patients were admitted to hospital as a result of psychotic symptoms or depression. The incidence of psychotic symptoms (12%) was significantly higher for patients receiving topiramate compared with 191 patients attending the department on gabapentin (0.5%) and 270 patients attending the department on lamotrigine (0.7%) P < 0.001. ‘Abnormal thinking’, consisting of mental slowing and word-finding difficulties, occurred in 31%. The incidence could be significantly reduced by using 25 mg dose increments fortnightly as opposed to 100 mg weekly ( P > 0.03). Although topiramate is an effective antiepileptic drug, its use is accompanied by a high incidence of particularly psychiatric side effects.
ISSN:1059-1311
1532-2688
DOI:10.1016/S1059-1311(98)80037-X