ONE-YEAR OBSERVATION OF TOPIRAMATE IN ADD-ON THERAPY IN PATIENTS WITH DRUG RESISTANT EPILEPSY

Introduction. Topiramate (Topamax, TPM) is an effective AED, used to treat simple partial, complex partial and secondary generalised to tonic sei zures. The drug's pharmakokinetic profile and the outcomes of clinical trials suggest that TPM may be used in both polytherapy and monotherapy. Objective. The aim of the study was to conduct a one-year observation of the effectiveness and safety of topiramate in patients with drug resistant epilepsy in the form of partial seizures with or without secondary generalisation. Material and methods. 86 patients (36 F, 50 M) were studied. The mean age of the patients was 30 years (13-61) and the mean duration of epilepsy was 19 years (2-55). Thirty-seven (41.2%) of the 86 patients with partial sei zures had secondary generalised seizures, 8 (8.9%) had secondary generalised to tonic-clonic seizures, and 41 (45.5%) had both types. The drug was administered twice daily for a mean daily dose of 5.2 mg/kg (0.8 -11.7). The patients were observed for 12 months. Results. Reduction of seizures by at least 50% was observed in 47 pa tients (54.7%), of whom 14 patients (16.3%) attained 100% relief of seizures, while seizure reduction exceeding 50% was observed in 33 patients (38.4%). Reduction of seizures by less than 50% was observed in 39 patients (45.3%). These figures were stable throughout the entire follow-up period. Side effects were registered and treatment was discontinued in 20% of the patients. Our clinical experience to date suggests that tolerance to TPM does not develop despite prolonged treatment with the drug. Only a small percentage of patients had to discontinue treatment due to clinical deterioration in the form of increased frequency of seizures.