Zarontin Proves Most Effective For Childhood Epilepsy Treatment

By Margarita Nahapetyan

A large-scale comparative study of three anti-seizure drugs came to the conclusion that the oldest drug Zarontin (ethosuximide) proved to be most effective when it came to treating a form of pediatric epilepsy, called childhood absence epilepsy.

According to the statistical data, about 17 per cent of kids with epilepsy have absence seizures, also known as petit mal seizures, which are characterized by 10- to 15-second seizure episodes, that can take place dozens or even hundreds of times during a day. Children with absence epilepsy do not have the convulsions that are typically associated with epilepsy, but they are at an increased risk for developing them at a later time in life. During the seizure episodes, people become unresponsive and may stop walking or talking in the middle of the sentence. Children with these seizures tend to perform poorly in school.

The new study from Cincinnati Children's Hospital in Ohio, involved children with the ages between 2.5 and 13 years old from 32 sites all across the United States. All the kids were newly diagnosed with epilepsy and did not have any other problems, such as autism. In the trial, they were randomly assigned for the treatment with one of the three drugs: 156 kids were initially given Zarontin, 149 were treated with Lamictal (lamotrigine), and 148 were taking Depakote (valproic acid). The children, their parents and clinicians were not aware which drug was being taken.

Zarontin, used since the late 50s, is the oldest and the most affordable among the three drugs, and the only one used only for the treatment of absence epilepsy. Depakote appeared on the market several years after Zarontin and has also been used for the treatment of other seizure disorders, bipolar disorder, and migraines. Lamictal was approved for the treatment of seizures in 1994. This drug has also been used for the treatment of bipolar disorder and is being studied for the treatment of migraine headaches.

In the study, the experts primarily analyzed whether the kids were free of seizures without serious side effects after a period of 16 weeks, with a small number of children continuing for as long as 20 weeks. The study also measured how the drugs influenced the children's ability to concentrate and pay attention.

The results revealed that 16 weeks after the start of treatment, 58 per cent of the children who were getting Depakote and 53 per cent of those who received Zarontin, were free of seizures, compared with 29 per cent of children who received Lamictal. The study's authors wrote that only 33 per cent of children who were taking Zarontin, showed significant problems with paying attention, compared to 49 perccent of those who received treatment with Depakote. For this reason the experts recommend that it is better to start treatment with Zarontin and in case the results do not prove satisfactory to switch to the other available medicines. If that too is not effective, then a combination of drugs should be used, they concluded.

The study was reported in March 4 edition of the New England Journal of Medicine.