title: Allopurinol as add-on therapy in refractory epilepsy: a double-blind placebo-controlled randomized study.
abstract: The antiepileptic effect of allopurinol was assessed in a double-blind, randomized, placebo-controlled, cross-over trial in 84 patients with epileptic seizures refractory to standard antiepileptic drugs (AEDs). During a retrospective baseline period, patients experienced at least four seizures of any type per month. The effects of allopurinol and matching placebo were examined for 4-month periods. Allopurinol dosage was 150 mg daily for children weighing < 20 kg and 300 mg daily for other patients. Efficacy analysis based on the Wilcoxon rank-sum test was conducted for the 80 patients who completed the study. No significant period effect or treatment-period interaction was noted. Allopurinol significantly reduced total seizures (p = 0.005), and secondarily generalized seizures (p = 0.0015). Median seizure reduction for total seizures was 10.5 and 27.9% for secondarily generalized seizures. Subjective preferences by clinicians evaluated blindly significantly favored allopurinol. No significant change occurred in the plasma concentration of concomitant AEDs between treatment periods, but serum urate decreased by 32% during allopurinol treatment. No clinically relevant side effects or changes in routine laboratory clinical chemistry or hematology were ascribed to allopurinol.
authors.affiliation: Epilepsy Center of Cuneo, Italy.
authors.forename: P G
authors.initials: PG
authors.lastname: Zagnoni
authors.forename: A
authors.initials: A
authors.lastname: Bianchi
authors.forename: P
authors.initials: P
authors.lastname: Zolo
authors.forename: R
authors.initials: R
authors.lastname: Canger
authors.forename: C
authors.initials: C
authors.lastname: Cornaggia
authors.forename: P
authors.initials: P
authors.lastname: D'Alessandro
authors.forename: P
authors.initials: P
authors.lastname: DeMarco
authors.forename: F
authors.initials: F
authors.lastname: Pisani
authors.forename: M
authors.initials: M
authors.lastname: Gianelli
authors.forename: L
authors.initials: L
authors.lastname: Verzé
mesh_terms: D000293:Adolescent; D000328:Adult; D000493:Allopurinol / Q000008:administration & dosage / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010919:Placebos; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood
chemical_list: D000927:Anticonvulsants; D010919:Placebos; D014527:Uric Acid; D000493:Allopurinol