Abstracts

In the last decade a number of new anti-epileptic drugs became available in the Netherlands indicated for add-on therapy in refractory partial epilepsy. Our aim is to compare in retrospect the efficacy, side effects, reasons for drop-out and reactions of different seizure-types on LTG, TPM, GBP and LEV.
In the Utrecht outpatients ward of a Dutch epilepsy centre we followed a total of around 600 patients with chronic epilepsy on the 4 mentioned drugs. Many patients used more than one of these drugs in different periods (and sometimes in combination). Data that were collected on each period consisted of seizure type and frequency, co-medication at start of each therapy, current co-medication status at that time, dosage of the drug to be studied, response to therapy, side effects and duration of therapy. The follow-up is currently still going on. There were 456 patients on LTG, 219 on TPM, 166 on GBP and 239 on LEV.
On average patients were taking 2 other AEDs at the start of the add-on therapy. In the LTG-group 59 patients became seizure-free (7.7%), in the TPM-group 21 (9.6%), in the GBP-group 7 (7.3%), in the LEV-group 30 (12.5%).
The preliminary analysis of the data indicates that there is no association between favourable outcome and specific seizure types.
148 stopped using LTG (32.5%), 126 TPM (57.5%), 96 GBP (57.8%) and 85 LEV (35.6%), either because of lack of efficacy or side effects.
There are considerable differences in efficacy and side-effects between the 4 studied drugs. It has to be mentioned that only patients who were not responder to treatment with LTG (the first available) were selected for treatment with TPM, GBP or LEV respectively.