Essential tremor (ET) is one of the most common neurological diseases, manifested by slowly progressive kinetic and postural tremor of the hands and sometimes head tremor.
One of the main drugs for the treatment of patients with ET is Epitomax. The Cochrane Review of the treatment of ET patients indicated that propranolol and primidone may be ineffective in 25-55% of ET patients and often have serious side effects, while Epitomax is proposed as a potentially useful drug for the treatment of ET patients. An analysis of three studies of a total of 309 patients showed a significant reduction in tremor and reduced functional disability in patients treated with Epitomax compared to those treated with placebo. Among the main side effects, paresthesia, loss of appetite, weight loss and memory impairment were noted.
There were significant clinical improvements in the use of topiramate in low doses (100 mg / day), which reduces the risk of side effects. In some patients, such phenomena as a decrease in appetite and a decrease in body weight can be considered as positive effects of the drug. Topiramate should be used with caution in patients with angle-closure glaucoma and nephrolithiasis.
There was a statistically significant and clinically significant decrease in tremor in patients treated with topiramate. At the same time, a relatively high frequency of side effects (paresthesia, nausea, drowsiness, fatigue, dyspepsia, loss of appetite with a decrease in body weight, psychomotor retardation) was noted when using this drug in high doses (300-400 mg/day). In this regard, it is recommended to use topiramate in lower doses. Potential visual impairment in patients with angle-closure glaucoma has also been reported. Topiramate was usually prescribed 2 times a day. The initial dose was 25 mg / day, followed by an increase of 25-50 mg / week. In conclusion, it is indicated that topiramate, apparently, is one of the most effective drugs for the treatment of ET, approaching the level of effectiveness of first-line therapy.
Migraine is a common neurological disease characterized by episodic or regular, usually unilateral, attacks of intense headache of a pulsating nature.
Some medications have shown sufficient effectiveness in the treatment of migraines. One of these drugs is Epitomax. According to the results of studies, the drug at a dose of 50-200 mg/day contributes to a significant reduction in the frequency of migraine attacks in adults, while the effect may persist even after discontinuation of administration.
According to the results of three randomized controlled multicenter studies, it was found that in 46.3% of patients taking Epitomax, the number of migraine attacks decreased by 50%, in 6% —the attacks stopped completely. According to the results of observation of patients with migraine in the long-term period (6 months after the start of taking Epitomax), a progressive decrease in the frequency of attacks with an increase in the duration of taking the drug was revealed. The effectiveness of Epitomax (50 mg / day), propranolol (80 mg/day) and valproic acid (400 mg/day) in terms of the frequency of headache, its intensity and duration is generally comparable.
Epilepsy is a brain disease characterized by a persistent predisposition to the occurrence of epileptic seizures, as well as neurobiological, cognitive, mental and social disorders.
Epitomax is used as monotherapy in patients with newly diagnosed epilepsy or to switch to monotherapy in patients with epilepsy, as well as as additional therapy in adults and children aged >2 years with partial or generalized tonic-clonic seizures and epileptic seizures against the background of Lennox — Gastaut syndrome. The drug is of interest primarily in cases where partial seizures are refractory to therapy. Studies have demonstrated the effectiveness of its use at a dose of 200-600 mg/day in relation to this type of attacks. A further increase in the dose did not lead to a decrease in the number of reported seizures, but increased the severity of side effects. Thus, the optimal dose that reduced the number of attacks by 50%, according to most scientists, is 400 mg/day.