What Is the Effect of Topiramate Use on Growth in Children With Epilepsy?

ObjectiveThe literature related to weight loss as a side effect of using topiramate (TPM) in pediatric patients is inconsistent. The aim of this study was to assess the effect of TPM on the growth of pediatric epileptic patients.MethodsThe electronic medical files of 50 pediatric epileptic patients who were prescribed TPM over 5 years were retrospectively reviewed. Cases treated with other antiepileptic drugs were the control group (n=60).ResultsHeight growth was similar in both groups. At the 6-12-month follow-up, there was a decrease in the average BMI in the TPM group of -0.81 kg/m2 (p=0.019) and an increase in the control group of +0.46 kg/m2 (p=0.023). Weight loss was noted in 21/50 (42%) of the TPM group as compared with 13/60 (22%) in the control group (p=0.02). More weight loss was observed in the overweight TPM group in 7/16 (44%) compared to none in the nine cases in the control group (p=0.03). After the one-year follow-up, the average change in weight was +1.73 kg (p=0.0001) and +3.53 kg (p=0.0001) in the TPM and control groups, respectively. In patients with normal initial BMI, the weight increased by +1.3 kg on average, compared to the group with a high initial BMI, which decreased by -2.55 kg.ConclusionTopiramate use has no negative effect on height growth in pediatric patients with epilepsy. While mild weight loss occurs frequently in the first year of treatment, weight gain resumes after the first year except in patients with a high initial BMI