Innovations in epilepsy management - An overview
Publication Type:Journal Article
Source:Journal of Pharmacy and Pharmaceutical Sciences, Volume 16, Number 4, p.564-576 (2013)
Keywords:absence, add on therapy, adjuvant therapy, aggressiveness, amitriptyline, anhidrosis, anorexia, aplastic anemia, asthenia, ataxia, behavior change, bipolar disorder, blood dyscrasia, blurred vision, carbamazepine, clobazam, cognitive defect, concentration loss, confusion, coordination disorder, depression, diazepam, diplopia, dizziness, dose response, drowsiness, drug antagonism, drug blood level, drug efficacy, drug formulation, drug mechanism, drug potentiation, drug safety, drug tolerability, drug withdrawal, dystonia, epilepsy, epileptic state, eslicarbazepine acetate, etiracetam, excitability, falling, fatigue, febrile convulsion, felbamate, focal epilepsy, gabapentin, gait disorder, gastrointestinal symptom, generalized anxiety disorder, generalized epilepsy, harkoseride, headache, human, hyponatremia, hypothermia, infantile spasm, insomnia, irritability, lamotrigine, language disability, Lennox Gastaut syndrome, leukopenia, liver failure, lorazepam, metabolic acidosis, myoclonus epilepsy, nausea, nephrolithiasis, nimodipine, norclobazam, nortriptyline, open angle glaucoma, otitis media, oxcarbazepine, paresthesia, paroxetine, perampanel, peripheral edema, phase 2 clinical trial (topic), phase 3 clinical trial (topic), phenobarbital, phenytoin, photosensitivity, primidone, rash, retigabine, review, rufinamide, sedation, side effect, somnolence, Stevens Johnson syndrome, stiripentol, stupor, suicidal behavior, tiagabine, tic, tonic clonic seizure, topiramate, toxic epidermal necrolysis, tremor, unindexed drug, unspecified side effect, urine retention, valproic acid, vigabatrin, visual field defect, visual impairment, weakness, weight gain, weight reduction, zidovudine, zonisamide
In the past twenty years, thirteen new antiepileptic drugs (AEDs) have been introduced, each differing in their efficacy spectrum, mechanism of action, pharmacokinetics, safety and tolerability profiles. These newer AEDs symbolize a welcoming future in the management of epilepsy because they are able to produce a remarkable reduction in seizure frequency in up to 40% to 50% of the patients who had been refractory to old generation drugs. Despite the current availability of these new drugs, only a few patients with truly refractory seizures can be made seizure free. Although the newer agents are not superior to that of the older drugs, some have been shown to be non-inferior in terms of their efficacy. They offer additional advantages like better tolerability, ease of use, reduced interaction profile. Even though in most situations the older generation drugs still represent the best choice, advancing studies show that in many conditions, new generation drugs may be entirely vindicated for initial therapy. This urges a need for the search of novel and more efficacious new antiepileptic drugs in the management of uncontrollable seizures. More direct comparisons of newer versus newer and newer versus older drugs in clinical trials, both for monotherapy and adjunctive therapy must be conducted. More than 20 compounds with promising antiepileptic and neuroprotective properties have been discovered and are under various stages of drug development.
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