Eslicarbazepine acetate: A novel agent for the adjunctive treatment of epilepsy

Eslicarbazepine acetate, a novel antiepileptic agent, has recently been marketed as an adjunctive therapy in adults with partial onset seizures with or without secondary generalization. Its mode of action is not fully elucidated but it is believed that it and its metabolites stabilize the inactivated state of voltage-gated sodium channels, preventing their return to the inactivated state. Eslicarbazepine acetate is extensively converted to eslicarbazepine, its major active metabolite. Its pharmacokinetic profile is unaffected by food, gender, age or moderate hepatic impairment; clearance is dependent on renal function and dose reduction is recommended in patients with a creatinine clearance < 60 ml/min. Eslicarbazepine acetate does not induce its own metabolism or clearance. Clinical trials have demonstrated efficacy in short and long term studies (up to 1 year) together with improvements in quality of life outcomes and depressive symptoms where these existed at baseline. Most adverse events were mild to moderate in intensity and occurred early in treatment; the most frequently reported events were dizziness, somnolence and headache. Trials using eslicarbazepine acetate as monotherapy are ongoing.