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Published on: June 12, 2018
Pharmacologic management of epilepsy: an update
1Veterans Affairs Medical Center, Seattle, Washington 98108, USA.
Summary
New antiepileptic drugs (AEDs) introduced in the 1990s offer improved options for refractory epilepsy. Despite not being ideal, these AEDs represent significant advancements over older treatments, though cost remains a barrier.
Area of Science:
- Pharmacology
- Neurology
- Clinical Therapeutics
Background:
- A 15-year gap existed between established and new antiepileptic drugs (AEDs).
- The 1990s saw the introduction of four novel AEDs, expanding treatment alternatives for refractory epilepsy.
Purpose of the Study:
- To evaluate the advancements and limitations of new AEDs compared to established ones.
- To discuss the potential therapeutic roles of new AEDs beyond adjunctive therapy.
Main Methods:
- Review of clinical trial data and pharmacological profiles of new AEDs.
- Comparison of new AEDs against established treatments for refractory epilepsy.
Main Results:
- New AEDs provide alternatives for patients with poorly controlled seizures, primarily indicated for adjunctive therapy.
- These newer agents demonstrate significant therapeutic advances over older AEDs.
- Despite advantages, new AEDs do not fully meet ideal drug criteria, and cost is a significant barrier to wider adoption.
Conclusions:
- New AEDs represent a significant therapeutic advance for refractory epilepsy management.
- Further research may support their use in monotherapy or initial treatment strategies.
- Addressing the cost barrier is crucial for maximizing the benefit of these novel antiepileptic drugs.
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