***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Despite the high incidence of seizures and epilepsy in the elderly , the tolerability and safety of anticonvulsants are rarely evaluated in this patient population . We compared the safety and tolerability of oxcarbazepine in a cohort of 52 patients aged 65 years and older and a group of 1574 adult patients ranging in age between 18 and 64 years . There was no significant difference between the two groups with respect to premature discontinuation due to adverse events . The four most common adverse events experienced by patients in the elderly group , irrespective of their causal relationship to oxcarbazepine , were vomiting ( 19 % ) , dizziness ( 17 % ) , nausea ( 17 % ) , and somnolence ( 15 % ) . Three patients developed an asymptomatic hyponatremia , with at least one serum sodium level below 125mEq/L. Elderly patients on concomitant natriuretic drugs were significantly more likely to develop serum sodium levels below 135mEq/L. The results indicate that oxcarbazepine is safe to use in elderly patients and that its tolerability in this age group is similar to that of younger adult patients In the last 5 years oxcarbazepine ( OXC ) has been registered in many countries for use as first-line and add-on treatment for partial seizures with or without secondarily generalized seizures ( PS ) and generalized tonic-clonic seizures without partial onset ( GTCS ) . Its use as monotherapy in adults with newly diagnosed epilepsy was investigated in this double-blind , r and omized , parallel-group comparison with phenytoin ( PHT ) .  A total of 287 adult patients , with either PS or GTCS , were r and omized . After retrospective baseline assessment , patients were r and omized to OXC or PHT in a 1:1 ratio . The double-blind treatment phase was divided into two periods : a flexible titration period of 8 weeks , followed by 48 weeks of maintenance treatment . In the efficacy analyses , no statistically significant differences were found between the treatment groups . Seventy patients ( 59.3 % ) in the OXC group and 69 ( 58.0 % ) in the PHT group were seizure-free during the maintenance period . A total of 56 of the patients in the OXC group discontinued treatment prematurely ( five because of tolerability reasons ) compared to 61 in the PHT group ( 16 for tolerability reasons ) . The number of premature discontinuations due to adverse experiences showed a statistically significant difference in favour of OXC . There was no statistically significant difference between the groups with respect to the total number of premature discontinuations . This trial provides further support for the efficacy and safety of OXC as first-line treatment in adults with PS and GTCS . In addition , the results show that OXC has significant advantages over PHT in terms of tolerability This observational study was performed to identify the clinical reasons leading physicians to opt for immediate or progressive procedures when switching patients from carbamazepine to oxcarbazepine  , and to evaluate the clinical feasibility of the two procedures in a general unselected patient population . Five hundred and twenty-seven patients ( aged 14 years or older , treated with carbamazepine as monotherapy or in combination therapy ) were recruited at 50 Italian centres and freely assigned to immediate ( n=361 ) or progressive ( n=166 ) switch procedures . Vital and clinical data ( including seizure frequency ) were comparable in the two groups at baseline . The proportion of patients with simple partial seizures only was significantly higher in the immediate group ( immediate : 33.0 % vs progressive : 23.5 % , p=0.0275 ) , whereas the proportion of patients on combination therapy was slightly higher in the progressive group ( immediate : 47.1 vs progressive : 55.4 % , p=0.0756 ) . At the end of the switch period , overall treatment satisfaction was greater in the immediate switch group , both in patients ( p<0.002 ) and physicians ( p<0.0005 ) . Physicians preferred the immediate over the progressive switch procedure . The only clinical features of patients found to relate to the physician?s choice of switch procedure were simple partial seizures only ( favouring the immediate switch ) and , possibly , combination therapy with other anti-epileptic drugs ( favouring the progressive switch ) . " Overnight " switching from carbamazepine to oxcarbazepine also appears feasible in most patients on polytherapy Objective : To evaluate the safety and efficacy of oxcarbazepine ( OXC ) 2,400 mg/day versus OXC 300 mg/day monotherapy in patients with medically refractory partial epilepsy . Background : OXC is primarily metabolized by reductase enzymes and , consequently , has a low propensity to inhibit or induce oxidative enzymes and a minimal potential for drug – drug interactions . The efficacy of OXC as monotherapy was shown in several comparative trials in patients with newly diagnosed epilepsy and in hospitalized patients undergoing evaluation for epilepsy surgery . Methods : A multicenter , double-blind , r and omized , parallel-group trial design was chosen to assess the antiepileptic efficacy of OXC as monotherapy in a refractory epilepsy patient population . Out patients aged 12 years or older with inadequately controlled partial seizures , with or without secondarily generalized seizures , were enrolled . Patients finished the trial by completing the double-blind phase or by meeting one of four predefined exit criteria : a twofold increase in partial seizure frequency in any 28-day period relative to baseline ; a twofold increase in the highest consecutive 2-day partial seizure frequency relative to baseline ; occurrence of a single generalized seizure if none occurred during the 6 months prior to r and omization ; or prolongation or worsening of generalized seizure duration or frequency requiring intervention . Adverse events ( AEs ) , vital signs , and clinical laboratory tests were evaluated . Results : The percentage of patients meeting one of the exit criteria was significantly lower ( p < 0.0001 ) for the OXC 2400 mg/day group ( 14/34 ; 41 % ) than the OXC 300 mg/day group ( 42/45 ; 93 % ) . In addition , there was a significant difference in time to exit in favor of the OXC 2400 mg/day group ( p = 0.0001 ) . In the intent-to-treat analysis , 12 % of patients in the OXC 2400 mg/day group were seizure-free compared with none in the 300 mg/day group . OXC was well-tolerated , with dizziness , fatigue , somnolence , and nausea being the most frequent AEs . Most of these AEs were transient and rated as mild to moderate in intensity . Conclusion : OXC is safe and effective in the treatment of patients with partial epilepsy previously receiving treatment with other antiepileptic drugs . The results of this trial are consistent with previous monotherapy trials with OXC This study compared immediate ( overnight ) and progressive switching to oxcarbazepine monotherapy in patients with partial seizures unsatisfactorily treated with carbamazepine monotherapy . Patients were r and omised to either an overnight  ( n = 140 ) or a progressive switch  ( n = 146 ) from carbamazepine to oxcarbazepine monotherapy at a dose ratio of 1:1.5 . The difference between the two switch groups in the mean monthly seizure frequency supported the equivalence of overnight and progressive switching ( difference of 0.02 excluding outliers ; 95 % confidence interval ( CI ) -0.74 , 0.78 ) . Following the switch from carbamazepine to oxcarbazepine , there was a reduction in median monthly seizure frequency in both the overnight group ( from 1.5 to 0 ; P = 0.0005 ) and the progressive group ( from 1.0 to 0.4 ; P = 0.003 ) . The proportion of seizure-free patients increased from 38 to 51 % ( P = 0.002 ) and 39 to 49 % ( P = -0.01 ) in the overnight and progressive groups , respectively . In addition , the proportion of patients experiencing no clinical ly significant adverse events did not differ between the two switch methods ( difference of 2.5 ; 95 % CI -4.1 , 9.0 ) . For patients who are unsatisfactorily treated with carbamazepine monotherapy , overnight switch to oxcarbazepine monotherapy is as effective and well tolerated as a progressive switch , therefore allowing simple and flexible individualised treatment . Switching to oxcarbazepine monotherapy appears to be beneficial for patients who are unsatisfactorily treated with carbamazepine monotherapy , independently of the switch method used Oxcarbazepine ( up to 1800 mg daily orally ) was given for 12 months to 61 adult epileptic patients in clinical practice , as  monotherapy ( n=52 ) or adjunctive therapy ( n=9 ) . Patients on monotherapy became seizure-free ( 76.9 % ) or experienced > or = 75 % seizure rate reduction , with two exceptions . In the adjunctive therapy group , one patient became seizure-free and two experienced a 50 - 75 % seizure rate reduction . These seizure-free rates are higher than those reported in the literature . The drug was well tolerated ; only two patients withdrew because of intolerance ( 3.3 % ) . Long-term data is essential when evaluating a drug for lifelong treatment . This study contributes to the growing body of 12-month evidence on oxcarbazepine Summary : Purpose : To evaluate the long‐term efficacy , tolerability , and safety of oxcarbazepine ( OXC ) in medically refractory partial epilepsy In many countries oxcarbazepine ( OXC ) has been registered for use as first-line and add-on treatment for patients with partial seizures with or without secondarily generalized seizures ( PS ) and generalized tonic-clonic seizures without partial onset ( GTCS ) . Its use as monotherapy in children and adolescents with newly diagnosed epilepsy was investigated in this double-blind , r and omized , parallel-group comparison with phenytoin ( PHT ) .  A total of 193 patients aged 5 - 18 years with either PS or GTCS were enrolled . After a retrospective baseline assessment , patients were r and omized to OXC or PHT in a 1:1 ratio . The double-blind treatment phase comprised two periods : an 8-week flexible titration period ; followed by 48 weeks maintenance treatment . In the efficacy analyses , there were no statistically significant differences between OXC and PHT . Forty-nine ( 61 % ) patients in the OXC group and 46 ( 60 % ) in the PHT group were seizure-free during the maintenance period . In total , 24 patients in the OXC group discontinued treatment prematurely ( two for tolerability reasons ) compared with 34 in the PHT group ( 14 for tolerability reasons ) . The number of premature discontinuations due to adverse experiences was statistically significantly lower in the OXC group than in the PHT group . Moreover , the odds of an individual discontinuing prematurely ( regardless of reason ) were almost twice as high in the PHT group . This trial provides further support for the efficacy and safety of OXC as first-line treatment in children and adolescents with PS and GTCS . In addition , the results show that OXC in these patients has significant advantages over PHT in terms of tolerability and treatment retention PURPOSE Previous research suggests that seizure freedom may be necessary to improve health-related quality of life ( HRQOL ) for epilepsy surgery patients , but little is known regarding the seizure-frequency reduction needed to improve HRQOL among medically treated individuals . METHODS With data from 134 adults with refractory complex partial seizures participating in a r and omized controlled antiepileptic drug ( AED ) trial , we compared the change in HRQOL across groups having different levels of change in seizure frequency : 100 % , 75 - 99 % , 50 - 74 % reduction , and 0 - 50 % increase or decrease . Changes over time within each seizure-reduction group also were assessed . HRQOL was measured by the  QOLIE-31 , QOLIE-89 , and SF-36 .  RESULTS Subjects who became seizure free reported significantly more positive change than those who did not on the QOLIE-31 and QOLIE-89 overall scores , the QOLIE-89 mental health , physical health , and epilepsy-targeted composites , as well as the SF-36 mental health summary score . Changes over time in overall QOLIE-31 and QOLIE-89 scores were significantly more positive for subjects who achieved seizure freedom ( i.e. , 100 % reduction in seizure frequency ) than for those who did not . No significant change in QOLIE-31 and QOLIE-89 overall scores was observed for subjects who did not achieve seizure freedom . CONCLUSIONS In this study , HRQOL improvement occurred primarily among patients who achieved complete seizure freedom . Many AED trials use a 50 % seizure-frequency reduction criterion as a trial end point , but measurable impacts of this degree of reduction in seizure frequency on HRQOL in this sample were not observed . These results further support striving for seizure freedom as an epilepsy care goal Objective : To evaluate the efficacy , safety , and pharmacokinetics of oxcarbazepine as adjunctive therapy in infants and young children ( 1 month to < 4 years ) . Methods : Children 1 month to < 4 years of age with inadequately controlled partial seizures taking up to two concomitant antiepileptic drugs ( AEDs 
    Output:
    
There was no significant difference between oxcarbazepine and carbamazepine for controlling the crises .
CONCLUSIONS There is moderate evidence indicating that oxcarbazepine is effective as an alternative treatment for partial or generalized epilepsy in children and adults who were refractory to previous treatment