Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Topiramate (Topamax-Janssen-Cilag Ltd) is a new drug for the treatment of adults with epilepsy. It is licensed for adjunctive treatment of partial seizures, with or without secondary generalisation, poorly controlled by conventional first-line regimens. Topiramate is the third add-on treatment for epilepsy to be marketed in the last 4 years. Does it have a specific place in the treatment of epilepsy?
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PMID:Topiramate--add-on drug for partial seizures. 881 Jan 29

In controlled clinical trials, topiramate (Topamax) has demonstrated efficacy in refractory patients with complex partial seizures and secondarily generalized tonic-clonic seizures. Approximately 45 percent of 534 patients had a > or = 50 percent reduction in seizure frequency. Limited open label trials have shown that topiramate has broad spectrum activity and may be effective in patients with primary generalized epilepsies. The efficacy of topiramate compares very favourably with the efficacy of other new antiepileptic drugs recently introduced.
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PMID:Efficacy of topiramate. 970 33

Topimarate (Topamax) is a novel antiepileptic drug. Its mode of action is multifactorial and involves blockage of voltage-dependent sodium channels. The drug was detected in a 15-year-old epileptic who died soon after switching seizure prescriptions. Topimarate was recovered by basic extraction with ethyl acetate and analyzed by gas chromatography-mass spectrometry using selected ion monitoring. Ions monitored were m/z 324 and m/z 110 for topiramate and m/z 98 for the internal standard mepivacane. The drug was quantitated in blood, vitreous humor, bile, stomach content, and liver: the concentrations were 8.9, 12.4, and 10.9 mg/L, 31 mg/total content, and 29 mg/kg, respectively. Topiramate was detected in urine but not quantitated. Other drugs identified in this case were 0.45 mg/L nordiazepam and 0.05 mg/L oxazepam in blood. No alcohol was detected in any of the specimens. The cause of death was seizure disorder with upper respiratory infection. The manner of death was determined as natural. To our knowledge, this is the first report of the presence of topiramate in postmortem specimens.
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PMID:Distribution of topiramate in a medical examiner's case. 1051 68

Topiramate (Topamax) has been registered since July 1998 and has market authorization for the Federal Republic of Germany as an additive drug for the treatment of patients (age 12 or older) suffering from intractable partial and secondarily generalized seizures. The anticonvulsant effect of topiramate is based on three mechanisms: (a) modulating the blocking of the Na channels activated by voltage, depending on status, (b) potentiation of GABAA-mediated inhibiting neurotransmission, and (c) inhibition of excitatory neurotransmission by blocking APMA glutamate receptors. Topiramate exhibits a substantial anticonvulsive effect on partial seizures both with and without secondary generalization. The median reduction in seizure frequency using topiramate as adjunct therapy was 44%. In 44% of patients, seizure frequency was reduced by more than 50%, and seizure reduction was more than 75% in nearly half of these (i.e., in 21% of all patients), while 5% of patients remained completely free of seizures. Adverse events most often caused central nervous disturbances. Weight loss, the development of renal calculi, and impairment of cognitive functions may occur. It is recommended to start therapy with topiramate at a daily dosage of 25 mg, increasing by 25 mg every week up to 200-400 mg/day but not exceeding 1000 mg/day.
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PMID:[Topiramate (Topamax). Pharmacological characteristics and current use in epilepsy treatment]. 1091 47

A rapid gas chromatographic method for the routine determination in serum of the new anticonvulsant drug topiramate (Topamax) (TOP) is described. The method involves extracting 0.50 mL of sample, previously adjusted to pH 9.5 with saturated borate buffer with ethyl acetate. One-microliter aliquots of the extract were injected into a 10-m x 0.53-mm i.d. x 0.5-microm 100% methyl silicone megabore capillary column connected to a nitrogen-phosphorus detector. The column temperature was initially at 170 degrees C for 0.1 min, then programmed at 10 degrees C/min to 240 degrees C, then 20 degrees C/min to 280 degrees C for 0.5 min. Under these conditions of the assay, the retention times of TOP and mepivicaine, internal standard, were 4.0 and 3.4 min, respectively. Quantitative determinations were performed with peak-height ratios of TOP to the internal standard. Calibration curves were linear from 2.5 to 150 mg/L TOP. The assay had a limit of quantitation of 2.5 mg/L. The overall within-run precision of the method yielded coefficients of variation (CV) of 3.9% at 10 mg/L (n = 10) and 3.1% at 100 mg/L (n = 10). The overall between-run precision calculated by three determinations on a single day for a week yielded CVs of 7.3% at 23 mg/L (n = 12) and 7.8% at 85 mg/L (n = 12). Common anticonvulsant and basic/neutral extractable drugs were found not to interfere with the assay. At present, no correlation has been demonstrated between trough plasma TOP concentrations and clinical efficacy. However, TOP values observed in our laboratory in serums from patients receiving adjunctive treatment for seizure disorders ranged from 2.5 to 35 mg/L.
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PMID:Rapid gas chromatographic procedure for the determination of topiramate in serum. 1104 77

The pharmacotherapy of seizure disorders has long relied on a few standard medications such as phenobarbital, phenytoin (Dilantin), valproate (Depakote), and others that represent the "first generation" of anticonvulsants. This article reviews the newer, "second-generation" anticonvulsants that were developed in the last decade. The addition of these second-generation agents has doubled the number of therapies available for the treatment of seizure disorders. They include felbamate (Felbatol), gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), oxcarbazepine (Trileptal), tiagabine (Gabitril), topiramate (Topamax), and zonisamide (Zonegran). This article describes the known side effects of the second-generation agents and reviews the adverse reactions of the first generation of anticonvulsants as a guide to potential toxicities. Reference tables are included that note usual dosages, available dosage forms, and tablet imprint. In addition, this article describes monitoring parameters and gives specific information regarding the use of these agents.
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PMID:Second generation anticonvulsant medications: their use in children. 1188 12

Topamax in combination with other antiepileptic medications was used in a treatment of 45 patients with different epilepsy types. The efficacy of topamax was shown in all types of epilepsy and in most types of epileptic seizures. Positive effect was revealed in 69% of the cases, in 22.5% complete remission was achieved. The best results were obtained in idiopathic generalized epilepsy (in respect to stopping generalized tonico-clonic seizures) and in the cases of symptomatic (cryptogenic) partial epilepsy (in the treatment of simple partial motor and secondary generalized seizures). Seizures aggravation was only 6.5% in complex partial and tonic axial paroxysms. In 19% of the patients, topamax efficacy decreased, with seizures frequency gradually returning to a baseline 1-3 months after the positive effect achievement. Side effects (SE) were detected in 24% of the cases. The most frequent ones were dose-dependent SE in relation to CNS in the absence of idiosyncratic reactions. Therapy withdrawal because of SE was necessary only in 11% of the cases. Topamax is considered a promising antiepileptic medication.
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PMID:[Clinical efficacy and tolerability of topamax in combined therapy of epilepsy]. 1283 May 3

Twenty-five epileptic patients, mean age 25.7 years, have been studied. Twenty-two of them were diagnosed with symptomatic partial epilepsy, 1--with criptogenic partial epilepsy and 2--with idiopathic partial epilepsy. Illness duration was estimated as follows: above 5 years--5 patients, above 10 years--10, above 20 years--4 and less than 5 years--6. Polymorphic seizures were detected in 56% of the cases and monomorphic ones, resistant to the previous traditional anticonvulsant therapy,--in 44%. Topamax was used as an add-on therapy to the previously prescribed anticonvulsants in initial dose of 25 mg daily, with a following continuous dose increase. The mean therapeutic dosage was 100 mg daily. Therapeutic efficacy was assessed during 3 months. Since 1 month of topamax adjunction to a treatment schedule, a mean frequency of all types of seizures was reduced. The best effect was found in the case of combination of simple partial and secondary generalized seizures. The medication was effective in 60-80% of the patients with strong resistance to traditional anticonvulsants. Topamax is concluded to be a highly effective antiepileptic medication, which gives new possibilities for a treatment of patients with partial epilepsy resistant to traditional drugs.
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PMID:[Topamax in the treatment resistance partial epilepsy]. 1457 74

To specify efficacy of topamax in different types of epileptic seizures and its influence on patient's quality of life (QL), the drug was assigned to 38 patients, aged 18-69 years, as mono- and polytherapy (in combination with other anticonvulsive medications). Topamax dosages ranged from 25-50 mg at a base-line to 600 mg. Treatment duration was 6-18 months. Positive effect of different extent was achieved in 95.7% patients. A seizures frequency decreased by 25% in 17.4% patients; by 50%--in 8.7%; by 75%--in 43.5%; a complete disappearance of seizures was detected in 30.4%. The results confirmed the earlier data received by the authors that topamax was most effective in generalized convulsive, partial and secondary generalized seizures. It exerts a less pronounced effect in myoclonic seizures and absences. After topamax treatment, a total QL index measured by WHO questionnaire increased by 5.2%. The drug is well tolerated and does not affect cognitive functions of the patients. It is concluded that currently topamax is one of the most effective antiepileptic medications.
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PMID:[Topamax in the treatment of epilepsy]. 1595 37

The aim of the study was to evaluate efficacy and tolerability of topamax in patients of different age with various types of epilepsy. The drug was prescribed as monotherapy and combined therapy to 114 patients (53 men, 61 women) who were divided into age groups as follows: early age children--16 patients, preschool and school children--20, pubertal children--16, adolescent--23, middle-age patients--38, elderly--1. During topamax treatment, a complete remission was achieved in 48% patients, reduction of seizures frequency (more than by 50%)--in 44% patients. Topamax was more effective by remission index in the pubertal children, adolescent and adults as compared to early age children. The same peculiarity was characteristic of topamax in the treatment of symptomatic epilepsy. This drug was well-tolerable in all the groups studied, with isolated cases of moderate side-effects (body mass reduction, irritability, allergic skin reactions, paresthesias).
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PMID:[Efficacy of topiramate (topamax) in epileptic patients of different age]. 1684 81


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