Document Detail


The role of new antiepileptic drugs.
MedLine Citation:
PMID:  11474769     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
For many years, epileptologists had few choices for treating seizures. Within the past 20 years several "new generation" antiepileptic drugs (AEDs) were introduced. The most recent additions include oxcarbazepine, levetiracetam, and zonisamide. New agents have been shown in clinical trials to offer similar efficacy compared with older, more established AEDs, but the new agents offer important improvements in safety. Although clinical trials to specifically measure the efficacy of the new AEDs in treating idiopathic generalized epilepsy are rare, the new agents have demonstrated efficacy in treating generalized tonic-clonic convulsions. Data for treatment of Lennox-Gastaut syndrome indicate a clear effect with lamotrigine or topiramate and possibly some effect with zonisamide and levetiracetam. Studies of juvenile myoclonic epilepsy and absence seizures suggest that zonisamide, lamotrigine, topiramate, and levetiracetam may be effective. Each of the new AEDs is effective in controlling partial seizures. These agents may also be appropriate choices for newly diagnosed patients or those whose conditions are refractory to treatment. In clinical trials, patients who are refractory to treatment are often given escalated doses to gain effect, but higher doses also result in more adverse events and higher withdrawal rates. Generally, the higher the dose, the greater the odds of withdrawal, with the exception of levetiracetam, which is not associated with increased withdrawal rates at high doses. Newly diagnosed patients are likely to be controlled with the first therapy given to them. It is therefore important to select an agent with the best safety, efficacy, and tolerability profile possible.
Authors:
J A French
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of managed care     Volume:  7     ISSN:  1088-0224     ISO Abbreviation:  Am J Manag Care     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-07-27     Completed Date:  2001-10-04     Revised Date:  2013-08-21    
Medline Journal Info:
Nlm Unique ID:  9613960     Medline TA:  Am J Manag Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S209-14     Citation Subset:  H    
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MeSH Terms
Descriptor/Qualifier:
Anticonvulsants / classification,  therapeutic use*
Carbamazepine / adverse effects,  analogs & derivatives,  therapeutic use
Dose-Response Relationship, Drug
Epilepsies, Partial / drug therapy
Epilepsy / classification,  drug therapy*
Epilepsy, Tonic-Clonic / drug therapy
Humans
Phenylcarbamates
Polypharmacy
Propylene Glycols / adverse effects,  therapeutic use
Randomized Controlled Trials as Topic
Treatment Outcome
Triazines / adverse effects,  therapeutic use
United States
Chemical
Reg. No./Substance:
0/Anticonvulsants; 0/Phenylcarbamates; 0/Propylene Glycols; 0/Triazines; 25451-15-4/felbamate; 298-46-4/Carbamazepine; U3H27498KS/lamotrigine; VZI5B1W380/oxcarbazepine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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