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The Effects on Cognitive Function and Behavioral Problems of Topiramate Compared to Carbamazepine as Monotherapy for Children with Benign Rolandic Epilepsy

 Hoon-Chul Kang  ;  Baik-Lin Eun  ;  Heung Dong Kim  ;  Dong Ho Song  ;  Eun Hye Ha  ;  Kyunghwa Lim  ;  Jung Chae Park  ;  Eun Sook Suh  ;  Byung Ho Cha  ;  Kyu Young Chae  ;  Joon Soo Lee  ;  Dong Wook Kim  ;  Joon-Sik Kim  ;  Han Ku Moon  ;  Chang Wu Lee 
 EPILEPSIA, Vol.48(9) : 1716-1723, 2007 
Journal Title
Issue Date
Adolescent ; Age Factors ; Anticonvulsants/adverse effects* ; Anticonvulsants/therapeutic use* ; Carbamazepine/adverse effects* ; Carbamazepine/therapeutic use* ; Child ; Child Behavior Disorders/chemically induced* ; Child Behavior Disorders/diagnosis* ; Child Behavior Disorders/epidemiology ; Child, Preschool ; Cognition Disorders/chemically induced* ; Cognition Disorders/diagnosis* ; Cognition Disorders/epidemiology ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Epilepsy, Rolandic/drug therapy* ; Epilepsy, Rolandic/psychology ; Fructose/adverse effects ; Fructose/analogs & derivatives* ; Fructose/therapeutic use ; Humans ; Neuropsychological Tests/statistics & numerical data ; Personality Inventory ; Topiramate ; Treatment Outcome
PURPOSE: To evaluate the cognitive and behavioral effects of topiramate (TPM) versus carbamazepine (CBZ) using efficacious doses of each drug as monotherapy for children with benign rolandic epilepsy. METHODS: A multicenter, randomized, open-label, observer-blinded, parallel-group clinical trial was conducted. TPM was introduced at a dose of 12.5 mg/day with the minimum target dose of 50 mg/day in patients <30 kg and 75 mg/day in patients >30 kg over 4 weeks. CBZ was started at a dose of 10 mg/kg/day with the minimum target dose of 20 mg/kg/day over 4 weeks. Additional individual escalation was allowed up to a maximum target dose. The primary study end point was change on a neuropsychological test battery after 28 weeks of treatment. RESULTS: Neuropsychological data were available for 88 patients (45 patients for TPM and 43 patients for CBZ). Of the cognitive variables measured, arithmetic showed significant worsening in TPM (p = 0.037). An additional test, for maze, also showed a significantly greater improvement for CBZ (p = 0.026). Of behavioral variables, no significant changes were found but the scores had a negative trend for the TPM. When 30 patients on the minimum target dose for TPM were compared to 40 patients treated with minimum target CBZ, there was no significant worsening of cognitive and behavioral effects in the TPM. CONCLUSION: The pattern of neuropsychometric changes with TPM seemed to be slightly worse overall than CBZ. However, outcome with the minimum target dose did not differ significantly in comparisons between the treatment groups.
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1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Heung Dong(김흥동) ORCID logo https://orcid.org/0000-0002-8031-7336
Song, Dong Ho(송동호) ORCID logo https://orcid.org/0000-0002-9647-3130
Lee, Joon Soo(이준수) ORCID logo https://orcid.org/0000-0001-9036-9343
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