From Georgetown University Medical Center
Study shows newer epilepsy drug has worse side effects than older drug
Cognition, word recognition worse in patients taking topiramate Washington, DC – Two commonly prescribed epilepsy dugs have varied cognitive side effects on patients, report doctors from Georgetown University Medical Center. Their findings are published in the May 13 issue of the journal Neurology.
In a double-blind, randomized study, researchers looked at 2 drugs, valproate--released in 1978 for the treatment of epileptic seizures, and topiramate, approved by the FDA in late 1996. Each drug was added to carbamazepine, a standard epilepsy treatment, and then given to patients with epilepsy. The cognitive effects on those patients taking topiramate were slightly, although noticeably, worse than those taking the older valproate for a subset of patients.
"If our ultimate goal is to enable patients to be seizure free with the least amount of side effects, it is our responsibility to study new drugs as they come to market and understand the depths of side effects compared against each other," said Dr. Kimford Meador, principal investigator and chair of neurology at Georgetown. "Cognitive effects are among a variety of adverse effects that drugs can produce."
Before this neuropsychological study, cognitive side effects had been reported during topiramate treatment, but effects relative to other antiepileptic drugs were unclear. This new research specifically measured if patients on one of the drugs had more difficulty with word recognition, speaking fluency, verbal memory, and other measures of cognition. Sixty-two patients completed all three test periods of the study.
"It is important to remember that even subtle differences between antiepileptic drugs can amount to a totally different experience and level of satisfaction or frustration for our patients," said Meador.
In related research, Dr. Meador continues to study the impact of other epilepsy medicines on unborn children.
Epilepsy is a disabling neurological disorder of repeated seizures caused by excessive or abnormal brain electrical discharges. Depending on the area of the brain affected, the seizures may appear in the form of convulsions, muscle jerks, a blank stare, or a loss of awareness.
"Epilepsy has a profound and quite sad impact on a patient's life," said Meador. "On top of the daily struggle to manage their debilitation, epileptics face an increased rate of death due to accidents and suffer great economic losses over their lifetime. Anything we can discover that will make their lives better is an important contribution."
According to The Centers for Disease Control, epilepsy and seizures affect about 2.3 million Americans, and result in an estimated annual cost of $12.5 billion in medical costs and lost or reduced earnings and production. The CDC reports about 10% of Americans will experience a seizure in their lifetime.
The study was funded by Ortho-McNeil Pharmaceuticals, maker of topiramate.
Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through our partnership with MedStar Health). Our mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis--or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing and Health Studies, both nationally ranked, and the world renowned Lombardi Cancer Center.