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[New anticonvulsants in everyday clinical use]
Dominik Zieglgänsberger1, Dominique Flügel1
11 Klinik für Neurologie, Kantonsspital St. Gallen, St. Gallen.
Therapeutische Umschau. Revue Therapeutique
|April 3, 2019
Summary
Newer anticonvulsants offer improved tolerability and fewer interactions but are not more effective. Epilepsy treatment selection is individualized, and surgery is a viable option for refractory cases.
Area of Science:
- Neurology
- Pharmacology
Background:
- The range of available anticonvulsant medications is expanding.
- Newer anticonvulsants generally exhibit better tolerability and reduced drug interaction potential compared to older agents.
Purpose of the Study:
- To review the current landscape of anticonvulsant therapies.
- To highlight considerations for selecting appropriate epilepsy treatments.
- To discuss the role of novel anticonvulsants and epilepsy surgery.
Main Methods:
- Review of current clinical practices and pharmacological data.
- Analysis of factors influencing anticonvulsant selection.
- Evaluation of the efficacy and indications for epilepsy surgery.
Main Results:
- Newer anticonvulsants do not demonstrate superior efficacy over older ones.
- Treatment selection is multifactorial, including epilepsy type, patient age, comorbidities, and reproductive desires.
- Epilepsy surgery presents a highly successful option for drug-refractory epilepsy.
Conclusions:
- Individualized treatment strategies are crucial for epilepsy management.
- Despite advances, novel anticonvulsants are needed for refractory epilepsy.
- Epilepsy surgery should be considered early for patients with inadequate response to two or more anticonvulsants.
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