title: Seizure worsening with topiramate amongst Indians with refractory epilepsy.
abstract: In a prospective open label add-on study on 95 patients (age 1-63 years, mean 17.76 +/- 13.83 years) with seizures refractory to conventional antiepileptic drugs (AEDs) and other new AEDs, the addition of Topiramate (TPM) resulted in seizure worsening in 18 patients (19%) necessitating drug withdrawal over an average follow-up period of 4.94 +/- 1.69 months. Patients who had seizure worsening were older (P = 0.02), were more likely to have had a history of status epilepticus in the past (P = 0.03), were on three conventional AEDs (P = 0.027) or had tried one of the other new AEDs in the past with poor response (P = 0.04). Seven of 18 patients who had seizure worsening with TPM (7.4%) experienced initial seizure worsening, probably representing the subgroup with 'true' seizure worsening whilst 11 (11.6%) had initial improvement followed by 'apparent' seizure worsening. Initial seizure worsening was noted to be significantly more in females when compared with males who worsened after initial improvement (P = 0.05).
authors.affiliation: Department of Neurology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: P R
authors.initials: PR
authors.lastname: Krishnan
authors.forename: M
authors.initials: M
authors.lastname: Tripathi
authors.forename: S
authors.initials: S
authors.lastname: Jain
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D005632:Fructose / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012640:Seizures / Q000139:chemically induced* / Q000188:drug therapy* / Q000503:physiopathology; D018709:Statistics, Nonparametric; D000077236:Topiramate
chemical_list: D000077236:Topiramate; D005632:Fructose