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Journal of Child Neurology
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Topiramate, Carbamazepine, and Valproate Monotherapy: Double-Blind Comparison in Children With Newly Diagnosed Epilepsy

James W. Wheless, MD

Department of Neurology, University of Texas Health Science Center at Houston, Houston, TX, James.W.Wheless{at}uth.tmc.edu.

Walter Neto, MD

Johnson & Johnson Pharmaceutical Research & Development, Raritan, NJ

Steven Wang, PhD

Johnson & Johnson Pharmaceutical Research & Development, Raritan, NJ

In a novel double-blind trial, topiramate was compared with the investigator's choice of carbamazepine or valproate as first-line therapy in patients as young as 6 years of age with newly diagnosed epilepsy. Among 613 patients enrolled in the trial, 119 (19%) were children or adolescents (6—16 years of age). No differences between fixed doses of topiramate (100 and 200 mg/day) and carbamazepine (600 mg/day) or valproate (1250 mg/day) were observed in efficacy measures: time to exit, time to first seizure, and the proportion of patients who were seizure free during the last 6 months of treatment. Topiramate 100 mg/day (2.0 mg/kg/day in this study population) was associated with the fewest discontinuations owing to side effects. Based on efficacy and tolerability, the recommended target dose for topiramate as first-line therapy in children and adolescents is 100 mg/day. (J Child Neurol 2004;19:135—141).

Journal of Child Neurology, Vol. 19, No. 2, 135-141 (2004)
DOI: 10.1177/08830738040190020901
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