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Updated: May 27, 2026
Electrophoretic Delivery of γ-aminobutyric Acid (GABA) into Epileptic Focus Prevents Seizures in Mice
Published on: May 16, 2019
[New antiepileptic drugs, and therapeutic considerations]
1Pest Megyei Flór Ferenc Kórház, Neurológiai Osztály, Kistarcsa. szupera@hotmail.com
Abstract:
Epilepsy is not a singular disease, but a variety of disorders. It affects up to 0.5% of the population. Over the past decade, researchers have made great advances in the field of epilepsy. These have been accompanied by the licensing of a great number of antiepileptic drugs. However, despite these efforts, up to 15-20% of patients have refractory epilepsy. The novel antiepileptic drugs must suit several requirements: higher efficacy, especially in resistant cases, better tolerability, and improved pharmacokinetic properties. Recently, three new drugs have been introduced to the market. Retigabine is a carbamic derivate, and its anticonvulsive properties are largely due to its ability to prolong the opening of neuronal voltage-gated potassium Kv7.2 and Kv7.3 channels. Lacosamide is a functionalized amino acid, and selectively enhances voltage-gated sodium channel slow inactivation. Eslicarbazepine acetate is a new member of the dibenzazepine family, and blocks the fast inactivated voltage-gated sodium channel. All three of them differ from the foregoing agents in several important ways, including new mechanism of action (retigabine, lacosamide), or pharmacokinetics (eslicarbazepine acetate). These novel anticonvulsants appear to be a safe and effective addition to the armamentarium for the treatment of patients with refractory epilepsy. However, it will take the consideration of new concepts in shaping the new therapeutic algorithm.
Insights
Three new antiepileptic drugs offer improved efficacy for refractory epilepsy. Retigabine, lacosamide, and eslicarbazepine acetate present novel mechanisms and pharmacokinetic profiles for better patient outcomes.
Area of Science:
- Neurology
- Pharmacology
Background:
- Epilepsy encompasses diverse disorders affecting up to 0.5% of the population.
- Despite advances and numerous antiepileptic drugs, 15-20% of patients experience refractory epilepsy.
- Novel antiepileptic drugs require enhanced efficacy, tolerability, and improved pharmacokinetics, particularly for resistant cases.
Purpose of the Study:
- To review recent advances in antiepileptic drug development.
- To highlight the mechanisms of action and properties of three novel drugs: retigabine, lacosamide, and eslicarbazepine acetate.
- To assess their potential role in managing refractory epilepsy.
Main Methods:
- Review of recent scientific literature on novel antiepileptic drugs.
- Analysis of the pharmacological properties and mechanisms of action of retigabine, lacosamide, and eslicarbazepine acetate.
- Evaluation of their potential clinical utility in refractory epilepsy.
Main Results:
- Retigabine prolongs the opening of Kv7.2 and Kv7.3 potassium channels.
- Lacosamide selectively enhances voltage-gated sodium channel slow inactivation.
- Eslicarbazepine acetate blocks fast inactivated voltage-gated sodium channels, differing in mechanism or pharmacokinetics from older drugs.
Conclusions:
- Retigabine, lacosamide, and eslicarbazepine acetate represent a safe and effective addition to treatments for refractory epilepsy.
- These novel anticonvulsants offer distinct mechanisms of action and pharmacokinetic profiles.
- Future therapeutic algorithms for epilepsy may incorporate these new agents and evolving treatment concepts.
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