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Electrophoretic Delivery of γ-aminobutyric Acid (GABA) into Epileptic Focus Prevents Seizures in Mice
Published on: May 16, 2019
Modern antiepileptic drugs: guidelines and beyond
Nikolas Hitiris1, Martin J Brodie
1Epilepsy Unit, Division of Cardiovascular and Medical Sciences, Western Infirmary, Glasgow G11 6NT, UK.
Current Opinion in Neurology
|March 16, 2006
Summary
New antiepileptic drugs offer more choices, but evidence of superiority is limited. Conflicting guidelines and new insights into pharmacoresistance highlight ongoing challenges in epilepsy treatment.
Area of Science:
- Neurology
- Pharmacology
- Epilepsy Research
Background:
- Since 1990, ten new antiepileptic drugs (AEDs) have been introduced.
- Comparative studies show some newer AEDs are suitable for monotherapy.
Purpose of the Study:
- Review the usage of new AEDs, focusing on recent data and guidelines.
- Explore hypotheses explaining pharmacoresistance in epilepsy.
Main Methods:
- Review of recent data on AED usage.
- Analysis of international treatment guidelines.
- Examination of hypotheses for pharmacoresistant epilepsy.
Main Results:
- Lamotrigine, gabapentin, topiramate, and oxcarbazepine are widely available for monotherapy.
- Zonisamide and pregabalin are approved as adjunctive therapy for partial epilepsy.
- Guidelines differ, with the UK advising against routine use of newer AEDs based on cost, unlike US guidelines.
Conclusions:
- New AEDs increase patient and physician options, but robust evidence for superiority over older drugs is scarce.
- Conflicting guidelines reflect the limited evidence base.
- Understanding pharmacoresistance is advancing, potentially explaining refractory epilepsy incidence.
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