Conversion from Valproic Acid to Topiramate for Epilepsy

A short-term, open-label study suggests tolerability and efficacy with this change, but methodological issues preclude the drawing of definitive conclusions.

Valproic acid (VPA) remains a commonly used antiepileptic drug, but many patients require alternate medications because of adverse effects or inefficacy. In this multicenter, open-label, single-arm, observational study of patients with epilepsy, researchers aimed to examine the tolerability and efficacy of converting to topiramate (TPM) as add-on or substitution therapy after failure (intolerability or lack of efficacy) of VPA monotherapy or combination therapy.

The intention-to-treat analysis included 147 patients (119 on VPA monotherapy at baseline). TPM was titrated up to a median daily dose of 150 mg (100 mg per day in combination TPM therapy). VPA could be withdrawn after several weeks at the discretion of the treating physician. Monthl…

Reviewing Author

Ellen J. Bubrick, MD