title: Retention rate of clobazam, topiramate and lamotrigine in children with intractable epilepsies at 1 year.
abstract: Clobazam (CLB), Topiramate (TOP) and Lamotrigine (LAM) are newer second-line antiepileptic drugs (AEDs) used in children. This is a single-centre retrospective observational study of the efficacy, tolerability and retention rate in 224 separate treatment episodes in 194 children, aged 0.1-16.7 years (median 9.4) over an 8 year period. The median age of epilepsy onset was 3.3 years (range 0-15.1). 79% started CLB, TOP or LAM as at least the 3rd AED, with 39% having been withdrawn from at least 2 AEDs. 53% had generalised and 37% idiopathic epilepsies. The maintenance doses for CLB ranged 0.12-3.50 mg/kg/day (mean 0.7); for TOP 0.45-32.0 mg/kg/day (mean 7.1) and for LAM 1.13-16.0 mg/kg/day (mean 5.6). The study comprised 75 person-treatment years for CLB, 56 for TOP, 124 for LAM.
  
  
  RESULTS
  CLB, TOP and LAM were well tolerated with 51%, 37% and 69% remaining on treatment beyond 1 year respectfully. 1 serious adverse event for CLB (inducing seizures) and 2 for LAM (rashes) were reported, and 60%, 47% and 39% had possibly and probably related adverse events for CLB, TOP and LAM respectively. Beyond 12 months seizure improvement (< 50% seizure frequency compared to baseline) was reported in 43%, 35% and 44% on CLB, TOP and LAM, including 5% and 8% remaining seizure free on CLB and LAM respectively.
  
  
  CONCLUSIONS
  Our results demonstrate the efficacy and tolerability of CLB, TOP and LAM in children with difficult to treat epilepsies and a good response in CLB and LAM, and a reasonable response in TOP beyond 12 months.
authors.affiliation: School of Clinical Sciences, University of Nottingham, UK.
authors.forename: J K A
authors.initials: JK
authors.lastname: Mills
authors.forename: T G
authors.initials: TG
authors.lastname: Lewis
authors.forename: K
authors.initials: K
authors.lastname: Mughal
authors.forename: I
authors.initials: I
authors.lastname: Ali
authors.forename: A
authors.initials: A
authors.lastname: Ugur
authors.forename: W P
authors.initials: WP
authors.lastname: Whitehouse
mesh_terms: D000293:Adolescent; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D000078306:Clobazam; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D000077213:Lamotrigine; D008297:Male; D010349:Patient Compliance / Q000523:psychology; D012189:Retrospective Studies; D012893:Sleep Wake Disorders / Q000139:chemically induced; D000077236:Topiramate; D016896:Treatment Outcome; D014227:Triazines / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D014227:Triazines; D000077236:Topiramate; D001569:Benzodiazepines; D000078306:Clobazam; D005632:Fructose; D000077213:Lamotrigine