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How About the New Antiepileptic Drugs?

Published online by Cambridge University Press:  18 September 2015

B.J. Wilder
B.J. Wilder*
Affiliation:
University of Florida College of Medicine, Department of Veterans Affairs Medical Center, Gainesville, Florida
*
University of Florida College of Medicine, Consultant in Neurology, Department of Veterans Affairs Medical Center, Gainesville, Florida, USA 32608-1197
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Abstract:

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No new antiepileptic drugs (AEDs) were licensed in the United States from 1978 to 1992. In late 1992, felbamate and gabapentin were recommended for approval, and in early 1993, lamotrigine. In July 1993, felbamate was licensed, and gabapentin and lamotrigine may soon follow. Lamotrigine, vigabatrin and clobazam are in use outside the US. Tiagabine, oxcarbazepine, fosphenytoin, topiramate, vigabatrin and zonisamide are in Phase II clinical testing in the US. All of the new AEDs are effective against partial and tonic-clonic seizures. Few controlled clinical trials have been done in patients with absence and myoclonic seizures. Mechanisms of action of the new drugs have not been clearly defined. The new AEDs will provide an opportunity to improve the care of epileptic patients. Even with optimal management with currently available drugs, some 30% of patients remain refractory to medical management.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 21 , Issue S3 , August 1994 , pp. S17 - S20
Copyright
Copyright © Canadian Neurological Sciences Federation 1994

References

REFERENCES

1.Swinyard, EA., Sofia, RD., Kupferberg, HJ.Comparative anticonvulsant activity and neurotoxicity of felbamate and four prototype antiepileptic drugs in mice and rats. Epilepsia 1986; 27: 27–34.CrossRefGoogle ScholarPubMed
2.Sachdeo, R., Kramer, LD., Rosenberg, A., Sachdeo, S.Felbamate monotherapy: controlled trial in patients with partial onset seizures. Ann Neurol 1992; 32: 386–392.CrossRefGoogle ScholarPubMed
3.Leppik, IE., Dreifuss, FE., Pledger, GW., et al. Felbamate for partial seizures: results of a controlled clinical trial. Neurology 1991; 41: 1785–1789.CrossRefGoogle ScholarPubMed
4.Theodore, WH., Raubertas, RF., Porter, RJ., et al. Felbamate: a clinical trial for complex partial seizures. Epilepsia 1991; 32: 392–397.CrossRefGoogle ScholarPubMed
5.Fuerst, RH., Graves, NM., Leppik, IE., et al. Felbamate increases phenytoin but decreases carbamazepine concentrations. Epilepsia 1988;29:488–491.CrossRefGoogle ScholarPubMed
6.Wilder, BJ., Campbell, KW., Gilmore, RL., et al. Felbamate for intractable epilepsy: a long-term study. Epilepsia 1991; 32: 59.Google Scholar
7.Dodrill, CB., Wilensky, AJ., Ojemann, LM., et al. Neuropsychological, mood, and psychosocial effects of gabapentin. Epilepsia 1992; 33(Suppl): 117.Google Scholar
8.Leppik, IE., Shellenberger, MK., Anhut, H., et al. Two open-label, multicenter studies of the safety and efficacy of gabapentin as add-on therapy in patients with refractory parital seizures. Epilepsia 1992; 33 (Suppl): 117.Google Scholar
9.Sivenius, J., Kalviainen, R., Ylinen, A., Riekkinen, P.Double-blind study of gabapentin in the treatment of partial seizures. Epilepsia 1991; 32: 539–542.CrossRefGoogle ScholarPubMed
10.Crawford, P., Ghadiali, E., Lane, R., Blumhardt, L., Chadwick, D.Gabapentin as an antiepileptic drug in man. J Neurol Neurosurg Psychiatry 1987; 50: 682–686.CrossRefGoogle ScholarPubMed
11.Leach, MJ., Marden, CM., Miller, AA.Pharmacological studies on lamotrigine, a novel potential antiepileptic drug: II. Neurochemical studies of the mechanism of action. Epilepsia 1986;27:490–497.CrossRefGoogle ScholarPubMed
12.Miller, AA., Wheatley, P., Sawyer, DA., Baxter, MG., Roth, B.Pharmacological studies on lamotrigine, a novel potential antiepileptic drug: I. Anticonvulsant profile in mice and rats. Epilepsia 1986; 27: 483–489.CrossRefGoogle ScholarPubMed
13.Jawad, S., Richens, A., Goodwin, G., Yuen, WC.Controlled trial of lamotrigine (Lamictal) for refractory partial seizures. Epilepsia 1989;30:356–363.CrossRefGoogle ScholarPubMed
14.Smith, D., Baker, G., Davies, G., Dewey, M., Chadwick, DW.Outcomes of add-on treatment with lamotrigine in partial epilepsy. Epilepsia 1993; 34: 312–322.CrossRefGoogle ScholarPubMed
15.Mikati, MA., Schachter, SC., Schomer, DL., Keally, M., Osborne-Shafer, P.Long-term tolerability, pharmacokinetic and preliminary efficacy study of lamotrigine in patients with resistant partial seizures. Clin Neuropharmacol 1989; 12: 312–321.CrossRefGoogle ScholarPubMed
16.Wilder, BJ., Campbell, KW., Uthman, BM., Hargrove, S., Barber, C.Safety, efficacy and pharmacokinetics of fosphenytoin, a phenytoin prodrug. Epilepsia 1992; 33: 117.Google Scholar
17.Leppik, IE., Boucher, BA., Wilder, BJ., et al. Pharmacokinetics and safety of a phenytoin prodrug given i.v. or i.m. in patients. Neurology 1990; 40 (3 Pt 1): 456–460.CrossRefGoogle ScholarPubMed
18.Wilder, BJ., Ramsay, RE., Marriott, J., Loewen, G.Safety and tolerance of intramuscular administration of fosphenytoin, a phenytoin prodrug, for 5 days in patients with epilepsy. Neurology 1993;43:A308.Google Scholar
19.Wilder, BJ., Slater, J., Malone, J., et al. Parental loading and maintenance of phenytoin with fosphenytoin, a phenytoin prodrug. Epilepsia 1993; 34 (Suppl 2): 27.Google Scholar
20.Eldon, MA., Loewen, GR., Voigtman, RE., et al. Safety, tolerance, and pharmacokinetics of intravenous fosphenytoin. Clin Pharmacol Ther 1993;53:212.Google Scholar
21.Tartara, A., Manni, R., Galimberti, CA., et al. Vigabatrin in the treatment of epilepsy: a long-term follow-up study. J Neurol Neurosurg Psychiatry 1989; 52: 467–471.CrossRefGoogle ScholarPubMed
22.Reynolds, EH., Ring, HA., Farr, IN., Heller, AJ., Elwes, RD.Open, double-blind and long-term study of vigabatrin in chronic epilepsy. Epilepsia 1991; 32: 530–538.CrossRefGoogle ScholarPubMed
23.Treiman, DM.Gamma vinyl GABA: current role in the management of drug-resistant epilepsy. Epilepsia 1989; 30 (Suppl 3): S31–S35.CrossRefGoogle ScholarPubMed
24.Browne, TR., Mattson, RH., Penry, JK., et al. A multicentre study of vigabatrin for drug-resistant epilepsy. Br J Clin Pharamcol 1989; 27 (Suppl 1):95S–100S.Google ScholarPubMed
25.Hammond, EJ., Ballinger, WD Jr, Lu, L., et al. Absence of cortical white matter changes in three patients undergoing long-term vigabatrin therapy. Epilepsy Res 1992; 12: 261–265.CrossRefGoogle ScholarPubMed
26.Rowan, AJ., Ahmann, P., Wannamaker, B., et al. Safety and efficacy of three dose levels of tiagabine HC1 versus placebo as adjunctive treatment for complex partial seizures. Epilepsia 1993; 34 (Suppl 2).Google Scholar
27.McQueen-Pierce, R., Uthman, BM., Hargrove, S., Wilder, BJ.Cognitive assessment during a double-blind antiepileptic drug trial. Epilepsia 1990; 31: 681.Google Scholar
28.Ranger, RJ., Penry, JK., Wilder, BJ., Riela, A., Margul, BL.Topiramate: a new antiepileptic drug for complex partial seizures – first use in epileptic patients. Neurology 1988; 38 (Suppl 1): 234.Google Scholar
29.Wilder, BJ., Penry, JK., Rangel, RJ., et al. Topiramate: efficacy, toxicity and dose/plasma concentrations. Epilepsia 1988; 29: 698.Google Scholar
30.Bulan, P., Froscher, W.Oxcarbazepine as a new antiepileptic substance. Drugs Today 1991; 27: 51–54.Google Scholar
31.Dam, M., Ekberg, R., Loyning, Y., Waltimo, O., Jakobsen, K.A doubleblind study comparing oxcarbazepine and carbamazepine in patients with newly diagnosed previously untreated epilepsy. Epilepsy Res 1989; 3: 70–76.Google ScholarPubMed