Main Entry Criteria. Adults with new-onset epilepsy

Comparator. Topiramate 100 and 200 mg/day, carbamazepine 600 mg/day, and valproate 1,250 mg/day

Number of Patients. 613

Primary Outcome Variable. Time to exit study

Important Secondary Variables. Seizure-free rate

Results. The four treatments were not significantly different in time to exit or seizure-free rate.

Main Entry Criteria. Adults and children with new-onset epilepsy

Comparator. Topiramate 500 versus 50 mg/day

Number of Patients. 252

Primary Outcome Variable. Time to exit study (time to second seizure)

Important Secondary Variables. Time to second seizure with time to first seizure as covariate

Results. Topiramate at 500 and 50 mg/day were not different in time to exit. Topiramate at 500 mg/day was superior to that at 50 mg/day when time to first and second seizure were used as covariates.

Main Entry Criteria. Adults and children (weighing at least 25 kg)

Comparator. Topiramate 400 versus 50 mg/day

Number of Patients. 470

Primary Outcome Variable. Time to first seizure

Important Secondary Variables. Seizure-free rate at 6 months

Results. Topiramate at 400 mg/day was significantly better than that at 50 mg/day in time to first seizure and seizure-free rate at 6 and 12 months.

Main Entry Criteria. Adults with medication-resistant seizures

Comparator. Pooled analysis of six RCTs of topiramate at 200, 400, 600, 800, and 1,000 mg/day, and placebo

Number of Patients. 743

Primary Outcome Variable. Median percentage seizure reduction

Important Secondary Variables. 50% responder rate

Results. The superiority of all five dosages of topiramate to placebo in responder rate and median percentage seizure reduction was statistically significant.

Main Entry Criteria. Children aged 2 to 16 years with medication-resistant seizures

Comparator. Topiramate 6 mg/kg/day versus placebo

Number of Patients. 86

Primary Outcome Variable. Median percentage seizure reduction

Important Secondary Variables. 50% responder rate

Results. Topiramate at 6 mg/kg/day was significantly superior to placebo for median seizure reduction. Topiramate was not significantly superior to placebo in 50% responder rate.

Main Entry Criteria. Adults with Lennox-Gastaut syndrome (electroencephalographic pattern of slow spike-wave, multiple seizure types [including drop attacks], and a history of atypical absence episodes)

Comparator. Topiramate at a maximum of 6 mg/kg/day versus placebo

Number of Patients. 98

Primary Outcome Variable (combined drop attacks and tonic-clonic seizures). Median percentage seizure reduction

Important Secondary Variables. 50% responder rate

Results. Topiramate was significantly superior to placebo for both median seizure reduction and 50% responder rate.

Main Entry Criteria. Adults and children (at least 4 years of age) with refractory generalized tonic-clonic seizures

Comparator. Topiramate at a target dosage of 6 mg/kg/day (maximum 400 mg/day) versus placebo

Number of Patients. 131

Primary Outcome Variable. Median percentage seizure reduction

Important Secondary Variables. 50% responder rate for both tonic-clonic seizures and all generalized seizures

Results. Topiramate was significantly superior to placebo for both tonic-clonic and all generalized seizures in median seizure reduction and 50% responder rate.

Main Entry Criteria (subset of study in the preceding text). Adults and children (at least 4 years of age) with refractory generalized tonic-clonic seizures who had juvenile myoclonic epilepsy

Comparator. Topiramate at a target dosage of 6 mg/kg/day (maximum 400 mg/day) versus placebo

Number of Patients. 11

Primary Outcome Variable; Important Secondary Variables. Median percentage seizure reduction, 50% responder rate for both tonic-clonic seizures and myoclonus

Results. In a small sample of patients with juvenile myoclonic epilepsy, topiramate reduced tonic-clonic and myoclonic seizures.

Main Entry Criteria. West syndrome

Comparator. Topiramate 24 mg/kg/day

Number of Patients. 11

Primary Outcome Variable. Frequency of infantile spasms

Important Secondary Variables. Ancillary seizures

Results. In a small sample of patients with West syndrome, topiramate reduced infantile spasms, and 5 of 11 patients were seizure free.