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Anticonvulsant Efficacy in Older Adults With Focal-Onset Epilepsy

November 08, 2017

Researchers sought to determine the efficacy, tolerability, and retention rates of a newer antiepileptic drug, zonisamide (ZNS), in older adults, as the drug has a unique structure and broad mechanistic profile.

Epilepsy is reportedly the third most common neurologic disease, following dementia and stroke, in older adults, and treatment decisions must be careful to consider age-related physiological changes and comorbidities in this population.

Researchers conducted a retrospective study, reviewing the charts of patients aged 60 and older with focal-onset epilepsy who were treated with ZNS in two tertiary epilepsy centers (Epilepsy & Behavior. 2017;76:19-23).

Charts of 85 adults were reviewed (41 males, 44 females) aged 60 and older (range: 60-81). Forty-seven of the patients (55.3%) were on monotherapy. The median and average doses of ZNS doses were 200 mg/day (range: 100-400) and 212.9 ± 84.2 mg/day, respectively.

With ZNS treatment, 67.1% of the patients (n = 57) were seizure-free for a median of 28 months (range: 10-56) whereas 20% (n = 17) of the patients had seizures that were unresponsive to ZNS treatment. The best seizure control was achieved in patients with poststroke epilepsy; seizure freedom was 80% in this subgroup.

The overall retention rate was found to be 83.5%; there was no significant relation between receiving poly- or monotherapy and discontinuation of ZNS (P = .18). Some of the patients lost weight (n = 32, 37.6%). Median weight loss was 8 kg (range: 2-16). There was no significant correlation between weight loss and the administered doses of ZNS (r = 0.34; P = .12).

Authors noted that the retrospective design caused some limitations in the study, however, they affirm that the results show that ZNS was well-retained with high efficacy in older adults with epilepsy.—Amanda Del Signore

For more articles like this, visit the Epilepsy Resource Center

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