单用不同剂量托吡酯与卡马西平治疗老年癫痫发作的疗效比较

目的:观察单用不同剂量托吡酯及卡马西平治疗老年癫痫病人的临床疗效和不良反应,探讨单用托吡酯更安全、更有效的给药方法。方法:老年癫痫病人120例,分为卡马西平组,31例,服用卡马西平(200～ 600 mg·d~(-1));单用托吡酯组,89例病人按服药剂量不同又分为,低剂量组47例(托_1组,100～200 mg·d~(-1)),高剂量组42例(托_2组,300～400 mg·d~(-1)):结果:托_1,组总有效率81％,托_2组总有效率74％;卡马西平组总有效率77％,3组比较无显著差异(P>0．05)。托_2组不良反应发生率(57％)高于托_1组(34％)(P<0．05)。托吡酯组主要不良反应为感觉异常、胃纳差、头痛、嗜睡头晕和体重减轻。结论:单用较小剂量托吡酯(100～ 200 mg·d~(-1))治疗老年癫痫发怍,疗效好,不良反应少而且轻。

Topiramate as monotherapy in different dosages vs carbamazepine in treating elderly patients with epilepsy

AIM: To observe the therapeutic effect and adverse reactions of topiramate in different dosages as monotherapy to treat the elderly patients with epilepsy and find out proper dosage. METHODS: One hundred and twenty elderly patients with epilepsy were divided into two groups. The carbamazepine therapy group, 31 patients were treated with carbamazepine 200-600 mg·d~(-1); and topiramate monotherapy groups(TPM groups), 89 patients were further divided into TPM_1 (100-200 mg·d~(-1)) and TPM_2 (300-400 mg·d~(-1)) groups basing on the dosages of topiramate. RESULTS: Seizures were reduced ≥50 % in 81 % of TPM, group, 74 % of TPM_2 group, and 77 % of carbamazepine group(P > 0.05). Adverse reaction rate of TPM_2 group (57 % ) was higher than that of TPM_1 group (34 %)(P < 0.05). Main adverse reactions of topiramate include paresthesia, loss of appetite, headache, dizziness and somnolence, weight loss. CONCLUSION: Topiramate monotherapy in treating the elderly patients with epilepsy is effective and with less adverse reactions, especially in lower dose (100-200 mg·d~(-1)) of monotherapy.