Epilepsy medical therapy: Difference between revisions
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* Drugs that affect voltage-dependent Na+ channels | * Drugs that affect voltage-dependent Na+ channels | ||
** Carbamazepin: | ** Carbamazepin: | ||
*** It can be used in treatment of both generalized and focal epilepsy. | |||
*** The initial dose is 2-3 mg/kg per day divided into at least two time. | *** The initial dose is 2-3 mg/kg per day divided into at least two time. | ||
*** The maximum dosing is 10 mg/kg three-times-daily. | *** The maximum dosing is 10 mg/kg three-times-daily. | ||
*** The most common side effects of this drug are GI disturbance, rash, hyponatremia and fluid retention.<ref name="pmid18981374">{{cite journal |vauthors=Hirsch LJ, Arif H, Nahm EA, Buchsbaum R, Resor SR, Bazil CW |title=Cross-sensitivity of skin rashes with antiepileptic drug use |journal=Neurology |volume=71 |issue=19 |pages=1527–34 |date=November 2008 |pmid=18981374 |doi=10.1212/01.wnl.0000334295.50403.4c |url=}}</ref> | *** The most common side effects of this drug are GI disturbance, rash, hyponatremia and fluid retention.<ref name="pmid18981374">{{cite journal |vauthors=Hirsch LJ, Arif H, Nahm EA, Buchsbaum R, Resor SR, Bazil CW |title=Cross-sensitivity of skin rashes with antiepileptic drug use |journal=Neurology |volume=71 |issue=19 |pages=1527–34 |date=November 2008 |pmid=18981374 |doi=10.1212/01.wnl.0000334295.50403.4c |url=}}</ref> <ref name="pmid4207990">{{cite journal |vauthors=Cereghino JJ, Brock JT, Van Meter JC, Penry JK, Smith LD, White BG |title=Carbamazepine for epilepsy. A controlled prospective evaluation |journal=Neurology |volume=24 |issue=5 |pages=401–10 |date=May 1974 |pmid=4207990 |doi= |url=}}</ref> | ||
** Eslicarbazepin | ** Eslicarbazepin | ||
*** It can be used for treatment of focal-onset seizures.<ref name="pmid29067682">{{cite journal |vauthors=Chang XC, Yuan H, Wang Y, Xu HQ, Hong WK, Zheng RY |title=Eslicarbazepine acetate add-on for drug-resistant partial epilepsy |journal=Cochrane Database Syst Rev |volume=10 |issue= |pages=CD008907 |date=October 2017 |pmid=29067682 |doi=10.1002/14651858.CD008907.pub3 |url=}}</ref> | |||
*** The initial dosage in adults is 400 mg/daily. The maximum dosing is maintenance dose of 800 mg daily.<ref name="pmid18508949">{{cite journal |vauthors=Almeida L, Minciu I, Nunes T, Butoianu N, Falcão A, Magureanu SA, Soares-da-Silva P |title=Pharmacokinetics, efficacy, and tolerability of eslicarbazepine acetate in children and adolescents with epilepsy |journal=J Clin Pharmacol |volume=48 |issue=8 |pages=966–77 |date=August 2008 |pmid=18508949 |doi=10.1177/0091270008319706 |url=}}</ref> | |||
*** The most common side effects of this drug are dizziness, drowsiness, nausea, headache, diplopia, fatigue, vertigo, ataxia, blurred vision, and tremor.<ref name="pmid25528898">{{cite journal |vauthors=Sperling MR, Abou-Khalil B, Harvey J, Rogin JB, Biraben A, Galimberti CA, Kowacs PA, Hong SB, Cheng H, Blum D, Nunes T, Soares-da-Silva P |title=Eslicarbazepine acetate as adjunctive therapy in patients with uncontrolled partial-onset seizures: Results of a phase III, double-blind, randomized, placebo-controlled trial |journal=Epilepsia |volume=56 |issue=2 |pages=244–53 |date=February 2015 |pmid=25528898 |pmc=4354260 |doi=10.1111/epi.12894 |url=}}</ref> | |||
** Lacosamide | ** Lacosamide | ||
** Oxcarbazepine | ** Oxcarbazepine | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
overview
Medical Therapy
Pharmacologic medical therapies for epilepsy is antiseizure drugs such as:
- Drugs that affect voltage-dependent Na+ channels
- Carbamazepin:
- Eslicarbazepin
- It can be used for treatment of focal-onset seizures.[3]
- The initial dosage in adults is 400 mg/daily. The maximum dosing is maintenance dose of 800 mg daily.[4]
- The most common side effects of this drug are dizziness, drowsiness, nausea, headache, diplopia, fatigue, vertigo, ataxia, blurred vision, and tremor.[5]
- Lacosamide
- Oxcarbazepine
- Phenytoin
- Rufinamide
- Drugs that affect Ca currents
- Ethosuximide
- Drugs that affect GABA activity
- Benzodiazepines
- Phenobarbital
- Tiagabine
- Vigabatrin
- Drugs that affect glutamate receptor
- Perampanel
- Drugs with multiple mechanisms of action
- Felbamate
- Topiramate
- Valporate
- Drugs with other mechanisms of action
- Brivaracetam
- Gabapentin
- Levetiracetam
- Pregabalin
References
- ↑ Hirsch LJ, Arif H, Nahm EA, Buchsbaum R, Resor SR, Bazil CW (November 2008). "Cross-sensitivity of skin rashes with antiepileptic drug use". Neurology. 71 (19): 1527–34. doi:10.1212/01.wnl.0000334295.50403.4c. PMID 18981374.
- ↑ Cereghino JJ, Brock JT, Van Meter JC, Penry JK, Smith LD, White BG (May 1974). "Carbamazepine for epilepsy. A controlled prospective evaluation". Neurology. 24 (5): 401–10. PMID 4207990.
- ↑ Chang XC, Yuan H, Wang Y, Xu HQ, Hong WK, Zheng RY (October 2017). "Eslicarbazepine acetate add-on for drug-resistant partial epilepsy". Cochrane Database Syst Rev. 10: CD008907. doi:10.1002/14651858.CD008907.pub3. PMID 29067682.
- ↑ Almeida L, Minciu I, Nunes T, Butoianu N, Falcão A, Magureanu SA, Soares-da-Silva P (August 2008). "Pharmacokinetics, efficacy, and tolerability of eslicarbazepine acetate in children and adolescents with epilepsy". J Clin Pharmacol. 48 (8): 966–77. doi:10.1177/0091270008319706. PMID 18508949.
- ↑ Sperling MR, Abou-Khalil B, Harvey J, Rogin JB, Biraben A, Galimberti CA, Kowacs PA, Hong SB, Cheng H, Blum D, Nunes T, Soares-da-Silva P (February 2015). "Eslicarbazepine acetate as adjunctive therapy in patients with uncontrolled partial-onset seizures: Results of a phase III, double-blind, randomized, placebo-controlled trial". Epilepsia. 56 (2): 244–53. doi:10.1111/epi.12894. PMC 4354260. PMID 25528898.