OBJECTIVE: To compare the tolerability of two different dose-initiation regimens 
of gabapentin for the adjunctive treatment of partial seizures.
BACKGROUND: Patient compliance is a key feature of successful outpatient 
pharmacologic therapy for epilepsy, and one aspect of compliance is simplicity 
of initiation. By using a rapid titration rate, leading to a rapid therapeutic 
gabapentin dose, perhaps there could be an improvement with compliance.
METHODS: Male or female patients, at least 12 years old, with a recent history 
of partial seizures with or without secondary generalization, were randomized to 
receive gabapentin (following a blinded placebo period of an undisclosed number 
of days) as either a Slow initiation (300 mg day 1, 600 mg day 2, then 900 
mg/day) or a Rapid initiation (900 mg/day immediately following the placebo 
lead-in).
RESULTS: Starting gabapentin therapy at an initial therapeutic dosage of 900 
mg/day is well tolerated by patients with epilepsy and is as safe as initiating 
with a titration schedule over 3 days. Of the four most common adverse events 
(somnolence, dizziness, ataxia, fatigue), only one, dizziness, occurred more 
often in the nontitrated (Rapid initiation) group than in the titrated (Slow 
initiation) group.
CONCLUSION: Initiation of gabapentin at 900 mg/day is as well tolerated as is a 
3-day titration, except for a higher incidence of dizziness.