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Clin Interv Aging. 2010 Apr 26;5:89-99.

Review of topiramate for the treatment of epilepsy in elderly patients.

Author information

  • 1Department of Psychiatry, Stanford University School of Medicine, Stanford, California 94305-5723, USA. brsommer@stanford.edu

Abstract

Individuals over 65 years of age experience the new onset of seizures at a prevalence rate of roughly twice that of younger adults. Differences in physiology, need of concomitant medications, and liability for cognitive deficits in this population, make the choice of anticonvulsant drugs especially important. This paper reviews topiramate (TPM), a treatment for many types of seizures, with the above risks in mind. In particular, we discuss efficacy and pharmacokinetics with emphasis on the older patient, and adverse events in both the younger and older adult. With most studies of TPM-induced cognitive deficits having been performed in younger adults and volunteers, we discuss the implications for the older adult. Even in studies of younger individuals, up to 50% discontinue TPM because of intolerable cognitive deficits. Most studies find specific declines in working memory and verbal fluency. In conclusion, we give recommendations for use of this antiepileptic drug in this population.

KEYWORDS:

cognition; elderly; epilepsy; pharmacokinetics; topiramate; treatment

PMID:
20458347
[PubMed - indexed for MEDLINE]
PMCID:
PMC2861844
Free PMC Article
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