Abstracts

RATIONALE: Oxcarbazepine(OXC)is a novel antiepileptic drug which structurally resembles carbamazepine, but has better tolerability and fewer interactions with other drugs. OXC was released for use in the spring of 2000 for pediatric and adult patients with epilepsy. The purpose of this review is to report our experience with OXC.
METHODS: We retrospectively reviewed the records of 20 consecutive patients treated with OXC at the Epilepsy Management Program at Stony Brook University Hospital from May 2000 until April 2001. Patients ranging in age between 3 and 50 years were followed with respect to dosage, efficacy ([gt] 50% seizure reduction), duration of treatment and adverse events. Dosage ranged from 600mg/day to 2400mg/day in adults. In children, 10mg/kg/day was a starting dose with gradual escalation to 40mg/kg/day.
RESULTS: Twenty patients were entered into the analysis. Seizures were classified as generalized (N=6) and complex partial with secondary generalization (N=14). Associated disorders were present in the majority and included: tuberous sclerosis, OTC deficiency, mental retardation, developmental delay, attention deficit disorder, cerebral palsy, hydrocephalus, depression, psychosis. All were on 1-2 AED[ssquote]s when OXC was started. Mean duration of treatment at the last clinic visit was 4 months. Efficacy of [gt]50% sezure reduction was reported in 20% of these patients. Two patients, swtitched from CBZ to OXC, remained seizure free. Sedation was a prominent adverse event in 13/20 (66%) of patients. The drug was discontinued in seven patients (35%), five due to lack of efficacy and two due to lethargy.
CONCLUSIONS: OXC appears to be an effective and well tolerated drug for children and adults with both partial and secondary generalized epilepsy. Slow initial titration is recommended to decrease the likelihood of problems with sedation.