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Epilepsia. 2009 Aug;50(8):1999-2001. doi: 10.1111/j.1528-1167.2009.02053.x. Epub 2009 Apr 6.

The influence of concurrent anticonvulsants on the efficacy of the ketogenic diet.

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The Johns Hopkins Hospital, Baltimore, MD 21287-1000, USA.


It is unknown if any particular anticonvulsants modify the likelihood of seizure reduction when used in combination with the ketogenic diet (KD). A retrospective study was performed of 217 consecutive children who started the KD from 2000-2007. Patients included did not have any changes to their anticonvulsant dose. Efficacy data at 3 months on the KD were analyzed with respect to the six most frequently used anticonvulsants in this cohort. A total of 115 patients were included. Children receiving phenobarbital in combination with the KD were significantly less likely to have a >50% seizure reduction (p = 0.003). Conversely, those receiving zonisamide in combination with the KD at onset were more likely to have a >50% reduction (p = 0.04). These results provide practical information to clinicians who are treating children receiving both the KD and anticonvulsants.

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