Abstracts

With the advent of eight new antiepileptic drugs in recent years, some of the older antiepileptic drugs have been forgotten as potentially efficacious adjunctive therapies for medically refractory epilepsy. This study is a review of 20 patients on ethotoin (Peganone) as adjunctive therapy for medically refractory epilepsy.
20 patients, ages three years through 59 years (mean = 26), were treated with ethotoin at a dose of 250-mg to 4000-mg/day (mean = 2119), achieving a mean blood level of ethotoin range 24.1[micro]g/ml (7.1-61.0) for a period of one month through 20 years (mean=4.6 years). Seizure types for therapy included generalized tonic-clonic, tonic/atonic, complex partial, and atypical absence seizures. Mean seizure frequency prior to ethotoin treatment for tonic-clonic seizures was 10/month, for tonic/atonic seizures was 301/month, and for atypical absence was not quantifiable but at least daily. (See table)
The most responsive seizure types were the tonic-clonic seizures, atonic/tonic seizures and complex partial seizures. Atypical absence had no clear response to the pharmacological intervention. Adverse events included tiredness; two reported reduced memory. No other significant adverse events were reported [amp] no significant changes in CBCs were seen.[table1]
Ethotoin appears to be an effective adjunctive antiepileptic medication in this small pilot series of 20 patients with particular efficacy in tonic-clonic, tonic/atonic and complex partial seizures. The dose that appears to be most effective appears to be in the higher range of 2-3 grams/day for the typical adult to effect this improvement.
[Supported by: Ovation Pharmaceuticals.]