March 4th, 2010
A milestone study of the three prescription drugs used to treat the most common form of childhood epilepsy has found that the oldest prescribed drug is still the most effective.
Researchers studied 453 children from 32 American medical centers to find that ethosuximide (Zarontin) was the most effective at treating and controlling absence (“petit mal”) epilepsy with the least side effects. Zarontin is one of the oldest anti-seizure medications available throughout the United States. The two other drugs involved in the study included Valproic acid (Valproate, Depakote), which came in second and lamotrigine (Lamictal), the newest drug, which came in third.
Around 1% of American children have epilepsy, and 10% of those children are diagnosed with “absence epilepsy”. This condition causes the child to stare blankly at nothing for short periods of time that may only last for five seconds. The children in the study had frequent electroencephalograms to measure brain activity, which showed that absence epilepsy causes problems with attention.
“This is the first real hard evidence of comparing the three most commonly used medicines, and finds one superior to the other two.”
“The conventional wisdom has been that if you control the seizures, that is enough,” said trial leader Dr. Tracy A. Glauser, director of the Comprehensive Epilepsy Center at Cincinnati Children’s Hospital Medical Center. “We found that about a third of them had attention problems when they started and that they continued. These kids need to have their seizures addressed, but also need further evaluation to have their attention problems addressed.”
The study looked at children ranging in age from 2.5 to 13 years, each recently diagnosed with epilepsy and free of any other conditions such as autism. The children were randomly assigned one of the three prescription drugs. The study measured whether they were free of seizures without severe side effects after 16 weeks. In addition, the study measured if the drugs affected the children’s ability to pay attention.
Zarontin prevented seizures in 53% of the children, slightly lower than the 58% “freedom-from-failure” rate of Valproate but better than the 29% for Lamictal. However, only 33% of those taking Zarontin had major attention problems, compared to 29% taking Valproate, the researchers revealed.
The treatment strategy developed from this study is to start with Zarontin, Glauser said. If the medicine does not work after four or five months, treatment will switch to Valproate. If the medication still does not work, either Lamictal or a mixture of drugs should be used. Over 90% of children respond to one of the treatments, Glaucer added.
“It was somewhat unexpected that the oldest of the drugs had as good an effect as the other and better side effects,” included study participant Dr. Shlomo Shinnar, director of the Comprehensive Epilepsy Management Center at the Children’s Hospital of Montefiore Medical Center in New York City.
Seizure control without the side effects of attention problems and behavior is important. However, as the study demonstrated, even the “best medications work only half the time” says Glauser. “We need to develop better medications or better algorithms to match children with medicines better.” With proper treatment however, many children with epilepsy go on with good, fulfilling lives.
For more information about the seizure-control medication Zarontin, Valproic Acid and Lamictal, visit http://www.orderonlinedrugs.com
