Ethosuxomide most effective in treating absence epilepsy

In an analysis of 3 common antiseizure medications used to treat absence epilepsy in children, ethosuximide was associated with the best outcomes overall compared with lamotrigine and valproic acid. These results were published in the March 4 issue of the New England Journal of Medicine.

This double-blind, randomized, controlled clinical trial enrolled 453 children from 32 US medical centers. Eligible children were aged 2.5 to 13 years and had recently been diagnosed with childhood absence epilepsy. The patients were randomly assigned to treatment with ethosuximide (n=156), valproic acid (n=148), or lamotrigine (n=149) for 16 weeks. Dosages were increased until the child reached seizure-free status, the maximum dose was reached, or criteria indicating treatment failure were met.

After 16 weeks, freedom from treatment failure was observed in 53% of ethosuximide-treated patients, 58% of valproic acid-treated patients, and 29% of lamotrigine-treated patients. There were no significant differences among the groups in the rate of discontinuation because of adverse events. Patients treated with ethosuximide were less likely than those treated with valproic acid or lamotrigine to experience attentional dysfunction.