Neurology Medical News about antiepileptic drugs;side effects

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The impact of side effects on long-term retention in three new antiepileptic drugs
Seizure - European Journal of Epilepsy, 05/08/09

Bootsma HP et al. – Based on a drug's retention rate primarily due to its side effect profile, the retention rate was highest for lamotrigine and lowest for topiramate, with intermediate retention rates noted for levetiracetam.

Methods

Study of long-term retention, percentage of pts withdrawing due to adverse events, percentage of pts achieving seizure freedom, and safety profile of the new anti-epileptic drugs lamotrigine, levetiracetam, and topiramate
Assessment of all pts treated with lamotrigine, levetiracetam, or topiramate in Epilepsy Centre
Analysis of each drug from introduction in Netherlands up to final assessment 2 yrs later

Results

Review of data from 1066 pts: 336 for lamotrigine, 301 for levetiracetam, 429 for topiramate
2-yr retention rates: 69.2% (lamotrigine), 45.8% (levetiracetam), 38.3% (topiramate)
Seizure freedom rates: lowest for lamotrigine; highest for levetiracetam
Drug discontinuation due to adverse events: 154/429 pts (35.9%) on topiramate, 52/336 (15.5%) on lamotrigine, 68/301 (22.5%) on levetiracetam
Mood and general CNS-effects common for lamotrigine and levetiracetam pts
Neurocognitive side effects most prevalent for topiramate pts
Positive effect on cognition frequent for lamotrigine pts