Efficacy and Safety of Gabapentin as an Add-On
Therapy in Refractory Partial Epileptic Patients
SOMCHAI TOWANABUT, M.D.*,
LEK RUNGREANGYINGYOD, M.Sc. **,
CHUTHAMANEE SUTHISISANG, Ph.D.***
Affiliation : *Department of Medical Services, Prasat Neurological Institute,
**Department of Pharmacy,
***Department of Pharmacology, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand.
AbstractThe study on the efficacy and safety of gabapentin as an add-on therapy trial was per
formed in 10 refractory partial seizure cases at Prasat Neurological Institute, Thailand from
September 1996 to July 1998. This was an open-labeled titration dose of gabapentin starting at
600 mg/day add-on to the previously prescribed conventional antiepileptic drugs (AEDs). In cases
that seizures could not be controlled, gabapentin dose was increased by 300 mg per day every
two weeks until the total dose of 3,000 mg or until the side effects became intolerable.
The result revealed that gabapentin reduced frequency, duration and severity of seizures
and also improved the patients' activities of daily living (ADL) even at the minimum dose of 600
mg. The optimal dose of gabapentin was in the range of 600 to 1,200 mg per day. Seven patients
were seizure free at the end of the study. There were some precipitating factors that interfered
with the efficacy of gabapentin in some patients such as stress, menstruation, fever, and alcohol
intake.
Weight gain, somnolence, nystagmus, and dizziness were the major adverse events in these
patients, whereas ataxia, tremor, and diplopia were found with gabapentin in a dose higher than
1,800 mg/day. These adverse events were mild and transient. No patients withdrew from the study
due to adverse drug reactions. In addition, gabapentin did not alter conventional AED blood level
and routine laboratory parameters.
In conclusion, gabapentin was effective and well tolerated as an add-on therapy in
refractory partial epileptic Thai patients.
Keywords : Epilepsy, Refractory Partial Seizure, Gabapentin, Partial Seizure
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