Topiramate in refractory partial-onset seizures in children, adolescents and young adults: a multicentric open trial.
OBJECTIVE
This study was to evaluate the efficacy and safety of topiramate (TPM) in refractory partial epilepsy in children, adolescents and young adults.


METHODS
We performed a prospective open label add-on study in 55 patients (age 2-30 years, mean 15 years) with refractory partial seizures. Topiramate was added to one or two other baseline drugs and the efficacy was rated according to seizure type and frequency.


RESULTS
TPM was initiated at a daily dose of 0.5-1 mg/kg, followed by a 2-week titration at increments of 1-3 mg/kg/24h, up to a maximum daily dose of 12 mg/kg. After 9 months of treatment, 11 patients (20%) had 100% fewer seizures and 25 patients (45%) had a more than 50% seizure reduction. TPM appeared to be effective both in cryptogenic (76.2%) and symptomatic (58.8%) partial epilepsies. Mild to moderate adverse events were present in 25 patients (45.4%), mostly represented by drowsiness, nervousness and hyporexia with or without weight loss.


CONCLUSIONS
TPM was an overall effective and safe add-on drug both in cryptogenic and symptomatic childhood refractory partial seizures, the adverse reactions being generally mild or moderate.
Clinic of Child Neuropsychiatry, Department of Pediatrics, Second University of Naples, Via Pansini, 5, 80131, Naples, Italy.
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Coppola
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Caliendo
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Terracciano
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Buono
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Pellegrino
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Pascotto
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004828:Epilepsies, Partial / Q000188:drug therapy*; D005260:Female; D005632:Fructose / Q000008:administration & dosage* / Q000031:analogs & derivatives; D006801:Humans; D008297:Male; D018696:Neuroprotective Agents / Q000008:administration & dosage*; D011446:Prospective Studies; D011605:Psychoses, Substance-Induced / Q000523:psychology; D000077236:Topiramate; D015431:Weight Loss / Q000187:drug effects
D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose