A retrospective audit of the perceived efficacy and tolerability of adjunctive gabapentin (GBT) therapy in patients with intractable epilepsy was carried out. The case-notes of 263 consecutive patients attending a tertiary referral centre in whom GBT had been added to concomitant anti-epileptic drugs were reviewed. There were 119 males (45%); the median age was 35 years (range 15–81 years) and the median duration of epilepsy was 20 years. The median dose of GBT administered was 1,600 mg (range 300–4,800 mg). Twenty-nine patients (11%) had a reduction in seizure frequency of greater than 50% and 7 (3%) achieved seizure freedom of 6 months’ duration at least while taking GBT. Side-effects were reported by 169 patients (61%) and in 40 (15%) an increase in seizure frequency of 50% occurred, this being the commonest reason for GBT withdrawal. The median duration of treatment was 4 months (range 0.03–47 months). Ten patients, in whom GBT therapy had proven ineffective in doses of 900–1,800 mg, were rechallenged with doses of 300–4,800 mg. One individual experienced a 50% reduction in seizure frequency and 1 an increase in seizures of at least 50%. GBT was generally well tolerated at high doses and rechallenge of a small number with GBT in doses up to 4,800 mg did not result in further improvement in seizure frequency in the majority.

Keywords:
Epilepsy, Gabapentin, Efficacy, Tolerability
1.
Stables JP, Bialer M, Johannessen SI, et al: Progress report on new antiepileptic drugs: A summary of the Second Eilat Conference. Epilepsy Res 1995;22:235–246.
2.
Meldrum BS: Update on the mechanism of action of antiepileptic drugs. Epilepsia 1996;37(suppl 6):S4–11.
3.
Petroff OA, Rothman DL, Behar KL, Lamoureux D, Mattson RH: The effect of gabapentin on brain gamma-aminobutyric acid in patients with epilepsy. Ann Neurol 1996;39:95–99.
4.
Shorvon S, Stefan H: Overview of the safety of newer antiepileptic drugs. Epilepsia 1997;38(suppl 1):S45–51.
5.
Leiderman DB: Gabapentin as add-on therapy for refractory partial epilepsy: Results of five placebo-controlled trials. Epilepsia 1994;35(suppl 5):S74–76.
6.
Morris GL: Efficacy and tolerability of gabapentin in clinical practice. Clin Ther 1995;17:891–900.
7.
Anonymous Commission on Classification and Terminology of the International League against Epilepsy: Proposal for revised classification of epilepsy and epileptic syndromes. Epilepsia 1989;30:392–397.
8.
Wong IC, Chadwick D, Mawer GE, Sander JWAS: Survey of the perceived efficacy and adverse reaction profiles of gabapentin, lamotrigine, vigabatrin (abstract). Epilepsia 1996;37:S80.
9.
Anonymous: Gabapentin as add-on therapy in refractory partial epilepsy: A double-blind, placebo-controlled, parallel-group study. US Gabapentin Study Group No 5. Neurology 1993;43:2292–2298.
10.
Vossler DG: Exacerbation of seizures in Lennox-Gastaut syndrome by gabapentin. Neurology 1996;46:852–853.
11.
Reeves AL, So EL, Sharbrough FW, Krahn LE: Movement disorders associated with the use of gabapentin. Epilepsia 1996;37:988–990.
12.
Cugley AL, Swartz BE: Gabapentin associated mood changes? (abstract). Epilepsia 1995;36:S72.
13.
Schantz D, Towbin JA, Spitz MD: Changes in mood and affect in patients on gabapentin (abstract). Epilepsia 1995;36:S73.
14.
Aconape J, Collins T: Weight gain associated with the use of gabapentin (abstract). Epilepsia 1995;36:S72.
15.
King JA, Bayles RL: Weight gain during add-on therapy using gabapentin (abstract). Epilepsia 1995;36:S72.
16.
Chadwick DW: An overwiew of the efficacy and tolerability of new antiepileptic drugs. Epilepsia 1997;38(suppl 1):S59–62.
1999
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