Extended Release Epilepsy Drug Works Better

A study led by University of Cincinnati scientists shows that one of the most commonly used epilepsy medications is more effective when administered in an extended-release rather than an immediate-release form.

Results of the multi-center study, published recently in the journal

Neurology,

showed that extended-release of the drug carbamazepine controls epileptic seizures more effectively, and with fewer side effects, than the immediate-release version.

This finding is important for epilepsy treatment, says lead author David Ficker, MD, assistant professor of neurology at the UC Academic Health Center and member the Neuroscience Institute in Cincinnati, because side effects—which include  sleepiness, dizziness, difficulty in coordination, confusion and double vision—make patients reluctant to take the drug.

“If we can improve how patients tolerate medication,” said Dr. Ficker, “they feel better, are more likely to take it—largely because they don’t have to take it so often—and consequently have an improved quality of life.”

For three months Dr. Ficker and his colleagues studied 458 epilepsy patients who were switched from taking the immediate-release formulation to the newer, extended-release version, in which the medication is delivered into the patient’s bloodstream over a 12-hour period.

The study participants experienced 35 percent fewer seizures per month compared with patients receiving the immediate-release formula, possibly because of the more stable blood level of medication that is usually achieved with an extended release formula, Dr. Ficker said.

“The significant decrease in seizure frequency,” said Dr. Ficker, “could also be due to an increase in the number of patients actually continuing to take the medication because of the reduction in side effects.”

Study co-authors included Michael Privitera, MD, of UC’s neurology department, and Tracy Glauser, MD, of Cincinnati Children’s Hospital Medical Center.

The other institutions involved were Johns Hopkins University School of Medicine, Baltimore, Rush Medical College, Chicago, and Ohio State University, Columbus,

Drs. Ficker, Privitera and Glauser and researchers at the participating institutions received honoraria from the study sponsor, Shire Pharmaceuticals, manufacturer of carbamazepine.

The Neuroscience Institute is a collaborative effort of nine academic departments at the UC College of Medicine, University Hospital and independent physician practice groups. The institute is dedicated to patient care, research, education and the development of new medical technologies.