Efficacy and tolerability of topiramate compared with carbamazepine in newly diagnosed adults with partial epilepsy

Objective:To evaluate the efficacy and tolerability of topiramate (TPM) versus carbamazepine (CBZ) in adults who were newly diagnosed with partial epilepsy. Methods: 133 adults with partial epilepsy who were diagnosed within 3 months were initiaily administrated with either TPM (25mg·d~(-1)) or CBZ (200mg·d~(-1)). The dosages were gradually escalated during the treatment until the optimal efficacy and tolerability of the therapy were achieved. The primary endpoints of the study were to evaluate the seizure frequency reduction by 50 percent,or no reduction and worsening prior to and post the dosing level, together with the patient proportion of discontinuation from the study due to adverse events at every dosing level in each treatment group. Results: The mean investigation and follow-up time were (8.10±6.35) months for TPM group, (15.69±10.23) months for CBZ group. The optimal dose range of TPM was 50～300mg·d~(-1), and CBZ 100～600mg·d~(-1). Overall efficacy of 75.9% and 68.0% were shown for the patients in the TPM and CBZ groups, respectively (P= 0.0336). Patients taking TPM presented a lower incidence of withdrawal from the study due to adverse events than those treated with CBZ (1.7% vs. 14.7% ). Conclusion : TPM showed a more favorable efficacy and safety in treatment of adult patients newly diagnosed with partial epilepsy than CBZ.