Efficacy and tolerability of topiramate versus valproic acid in adults newly diagnosed with epilepsy

Objective: To compare the efficacy and tolerability of topiramate (TPM) to valproic acid (VPA) as monotherapy in adults newly diagnosed with epilepsy. Methods:124 adult patients who were diagnosed with epilepsy within 3 months were randomly administered with an initial dose of TPM 25 mg daily (n = 60,qd) or VPA 200 mg daily (re = 64, bid). The optimal dosages of both drugs were then adjusted based on the episodes status and tolerability of patients during the follow-up treatment. The overall efficacy of the therapy was evaluated based on the improvements of seizure frequency pre-and post-treatment and the ratio of discontinuation due to adverse events. Results:The mean period patients had TPM and VPA was (8.10±6.44) and (14.16±11.75) months, respectively. The optimal dosages of TPM and VPA were 50～300 and 200～1500 mg·d-1, respectively. Compared with the efficacy rate of 59. 38% in VPA-treated patients, TPM-treated patients experienced a significant improvement rate of 78.33% in seizure control and frequency reduction (P =0.0383). The patients tolerated TPM better than VPA. Conclusion:TPM offered a better option than VPA in the treatment of adult patients with epilepsy.