FELBAMATE AS ADD-ON THERAPY

Felbamate is a novel anti-epileptic drug (AED) which has recently been associated with reports of aplastic anaemia and liver failure, We hav e conducted an open-label add-on assessment of the tolerability and ef ficacy of this compound in 111 adult patients with refractory epilepsy attending a tertiary referral centre. The mean follow-up period was 4 months (range 1-8 months). Sixty-three (57%) were ongoing, 38 (34%) h ad discontinued felbamate and a further 10 (9%) were withdrawing, Reas ons for discontinuing felbamate were adverse events in 23 (21%), incre ase in seizures in 11 (10%) and lack of efficacy in 14 (12%). Behaviou ral disturbances occurred in 14 patients, being the most likely advers e event to result in discontinuation. No cases of aplastic anaemia or liver failure were observed in this group. Felbamate appears to be a b road-spectrum AED. Seven percent of the patients had more than 95% sei zure reduction (2 patients were seizure free), whilst a further 13% ha d significant improvement (>50% reduction in seizure frequency). In co nclusion, felbamate seems to be an effective AED. In view of its assoc iation with potentially life-threatening complications, its use should however be restricted to patients with medically refractory epilepsy.