New antiepileptic drugs--an overview

The last ten years of the 20th century is called in neuroscience "decade of the brain". This period has brought many new antiepileptic drugs (AEDs) to the practising physician. New AEDs include: vigabatrin, lamotrigine, topiramate, tiagabine, gabapentin, oxcarbazepine, levetiracetam and zonisamide (not registered in Poland). The development of these drugs was under the current epilepsy theory (balance-disturbances between inhibitory and excitatory neurotransmitters in the brain). Mechanism of action of the new AEDs is due to increase of the GABA-system activity and/or reaction with ion-channels events in neurons. The aim of the study was an overview of the current literature on the new AEDs in the treatment of seizures and epileptic syndromes. Data from literature show that the new AEDs are better tolerated, have fewer drug interactions and seem to affect cognitive functions to a lesser degree compared to the conventional drugs. Most of them are recommended to an add-on therapy of partial seizures with/without second generalization, although there are more evidences on efficacy of new AEDs in monotherapy. The new AEDs seemed to be similar to the conventional drugs in efficacy, but superior in tolerability. New AEDs with more selective activity and lower toxicity have been significant improved the quality of life in the epileptic patients. Numerous chemical compounds with potential antiepileptic activity are in experimental and clinical development.