Efficacy of felbamate in therapy for partial epilepsy in children.
Thirty children (2 to 17 years of age) with refractory partial seizures received open-label felbamate as an add-on medication to their background antiepileptic drugs. The dose was increased up to a maximum of 45 mg/kg. Compared with baseline seizure activity, there was a 53% decrease in seizure frequency during felbamate therapy; 50% of the patients had more than a 50% decrease in seizure frequency. Patients older than 10 years of age were more likely to have a favorable response. Age correlated positively with felbamate concentrations and negatively with apparent felbamate clearance. Transient weight loss occurred in 57% of the patients; the weight loss was maximal after 12 weeks of initiation of felbamate, and subsided after the twentieth week of treatment. Anorexia and insomnia were reported in 20% and 16% of the patients, respectively. Adverse effects were generally tolerable; felbamate therapy was discontinued because of side effects in only one patient, because of a rash. We conclude that felbamate can be a useful and well-tolerated medication in the treatment of refractory partial epilepsy in children. However, increased apparent clearance of this drug in younger children should be considered in treatment of this age group.
Carmant
L
L
Department of Neurology, Children's Hospital, Boston, MA 02115.
Holmes
G L
GL
Sawyer
S
S
Rifai
N
N
Anderson
J
J
Mikati
M A
MA
D000293:Adolescent; D000367:Age Factors; D000855:Anorexia / Q000139:chemically induced; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004338:Drug Combinations; D004361:Drug Tolerance; D004828:Epilepsies, Partial / Q000188:drug therapy*; D004829:Epilepsy, Generalized / Q000188:drug therapy; D000078328:Felbamate; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D048448:Phenylcarbamates; D011409:Propylene Glycols / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D012449:Safety; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced; D015431:Weight Loss / Q000187:drug effects
D000927:Anticonvulsants; D004338:Drug Combinations; D048448:Phenylcarbamates; D011409:Propylene Glycols; D000078328:Felbamate