Topiramate for Lennox-Gastaut Syndrome
In August 2001, the U.S. Food and Drug Administration (FDA) approved topiramate (Topamax®) tablets and sprinkle capsules as an adjunctive treatment for Lennox-Gastaut syndrome (LGS) in adults and children 2-16 years of age in that country.
A study at 12 sites involved 98 persons with symptoms associated with LGS who experienced a minimum of 60 seizures during the month preceding the study. Participants continued to take previously prescribed anti-seizure medications (AEDs), plus either topiramate as an adjunctive treatment or a placebo.
The double-blinded portion of the study (11 weeks long) demonstrated that topiramate can significantly reduce both the severity of seizures and the number of tonic seizures (drop attacks) when used adjunctively with 1 or 2 other AEDs. 52% of family members caring for participants who received topiramate reported an overall improvement in seizure activity.
T
he most common side effects seen in children taking both topiramate and other AEDs included excessive drowsiness, loss of appetite, fatigue, nervousness, difficulty with concentration / attention, weight loss, aggressive reaction and memory difficulties.
The most common types of side effects in adults taking both topiramate and other AEDs included sleepiness, dizziness, poor co-ordination, speech difficulties, slowed thinking (psychomotor slowing), blurred or double vision, memory difficulties and changes in sensation.
In Canada, topiramate is indicated for adults and children 2 years and older as an adjunctive therapy for the management of seizures which are not controlled satisfactorily with conventional therapy.
The safety and efficacy of topiramate in children younger than 2 years of age has not been established.
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