An audit of topiramate use in a general neurology clinic

Seizure. 1998 Jun;7(3):207-11. doi: 10.1016/s1059-1311(98)80037-x.

Abstract

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 therpay 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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ambulatory Care / statistics & numerical data
  • Anticonvulsants / adverse effects*
  • Child
  • Cognition / drug effects
  • Depression / chemically induced
  • 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
  • Retrospective Studies
  • Topiramate
  • United Kingdom

Substances

  • Anticonvulsants
  • Topiramate
  • Fructose