Back to Journals » Clinical Interventions in Aging » Volume 5

Review of topiramate for the treatment of epilepsy in elderly patients

Authors Sommer B, Fenn H

Published 7 April 2010 Volume 2010:5 Pages 89—99


Review by Single-blind

Peer reviewer comments 3

BR Sommer1, HH Fenn2

1Department of Psychiatry, Stanford University School of Medicine, Stanford, California USA; 2Palo Alto VA Healthcare System, Acute Geropsychiatry Unit, Menlo Park Division, Menlo Park, California, USA

Abstract: Individuals over 65 years of age experience the new onset of seizures at a prevalence rate of roughly twice that of younger adults. Differences in physiology, need of concomitant medications, and liability for cognitive deficits in this population, make the choice of anticonvulsant drugs especially important. This paper reviews topiramate (TPM), a treatment for many types of seizures, with the above risks in mind. In particular, we discuss efficacy and pharmacokinetics with emphasis on the older patient, and adverse events in both the younger and older adult. With most studies of TPM-induced cognitive deficits having been performed in younger adults and volunteers, we discuss the implications for the older adult. Even in studies of younger individuals, up to 50% discontinue TPM because of intolerable cognitive deficits. Most studies find specific declines in working memory and verbal fluency. In conclusion, we give recommendations for use of this antiepileptic drug in this population.
Keywords: topiramate, elderly, epilepsy, treatment, cognition, pharmacokinetics

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]