Role of topiramate in adults with intractable epilepsy, mental retardation, and developmental disabilities

Seizure. 2002 Jan;11(1):47-50. doi: 10.1053/seiz.2001.0571.


The efficacy and safety of topiramate in patients with intractable mixed seizures, mental retardation (MR), and developmental disabilities (DD) were investigated. Twenty patients (eight females and 12 males) aged 21-57 years old with intractable epilepsy with mixed seizures, MR [profound (five), severe (three), moderate (two), mild (eight) and borderline (two)], and DD were treated with adjunctive topiramate 25 mg per day for 1 week followed by titration to clinical response (range 50-350 mg per day). Other antiepileptic drugs (AEDs) were decreased simultaneously. Topiramate therapy was discontinued in four patients for adverse events consisting of disorientation, unsteadiness, and pneumonia (one patient); anaphylactic shock from a tuna fish allergy (one); patient choice (one); and loss to follow-up (one). Seizures improved by gt-or-equal, slanted 50% in 11 of 16 patients (69%). Two patients (13%) were seizure free, including one patient who prior to topiramate therapy was seizure free but experiencing an intolerable adverse effect during therapy with another AED. Seizure duration and/or severity decreased in seven patients (44%). An increase in alertness was observed in 11 patients (59%). Topiramate was associated with improvement in seizure severity and alertness in this series and may be useful as adjunctive therapy in patients with mixed seizures, MR, and DD.

MeSH terms

  • Adult
  • Adverse Drug Reaction Reporting Systems
  • Anticonvulsants / adverse effects
  • Anticonvulsants / therapeutic use*
  • Child
  • Comorbidity
  • Developmental Disabilities / diagnosis
  • Developmental Disabilities / drug therapy*
  • Dose-Response Relationship, Drug
  • Electroencephalography / drug effects
  • Epilepsy / diagnosis
  • Epilepsy / drug therapy*
  • Female
  • Fructose / adverse effects
  • Fructose / analogs & derivatives
  • Fructose / therapeutic use*
  • Humans
  • Intellectual Disability / diagnosis
  • Intellectual Disability / drug therapy*
  • Male
  • Middle Aged
  • New York
  • Topiramate
  • Treatment Outcome


  • Anticonvulsants
  • Topiramate
  • Fructose