Gabapentin as add-on therapy in children with refractory partial seizures:A 12-week, multicentre, double-blind, placebo-controlled study

Purpose: To evaluate the efficacy and safety of gabapentin (Neurontin; GBP) as add-on therapy for refractory partial seizures in paediatric patients a ged 3-12 years. Methods: After a 6-week baseline period, 247 patients (54 centres) entered a 12-week double-blind phase and were randomized to receive either GBP (t.i .d., titrated to 23-35 mg/kg/day) or placebo. Seizure activity and type wer e recorded daily. Efficacy variables included Response Ratio (RRatio), resp onder rate, and percentage change in frequency (PCH) for all partial seizur es; PCH and RRatio for individual types of partial seizures; and investigat or and parent/guardian global assessments of seizure frequency and patient well-being. Results: RRatio for all partial seizures was significantly lower (better) f or GBP-treated patients (p = 0.0407). Responder rate favored GBP, but the d ifference between treatment groups was not statistically significant. Media n PCH for all partial seizures for the GBP treatment group (-17.0%) was bet ter than that for the placebo group (-6.5%). Median PCH for specific seizur e types showed GBP to be most effective in controlling complex partial seiz ures (-35%) and secondarily generalized seizures (-28%) when compared with placebo (-12%, +13%, respectively). A greater percentage of GBP-treated pat ients exhibited improvement according to investigator and parent/guardian g lobal assessments, with a statistically significant difference observed in the parent/guardian global assessment of seizure-frequency reduction (p = 0 .046). Three GBP patients and one placebo patient were seizure free during the double-blind treatment period. GBP was well tolerated. Conclusions: GBP was effective and well tolerated as an add-on therapy for partial seizures in paediatric patients with previously drug-resistant seiz ures.