Epilepsy medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

overview

Pharmacologic medical therapies for epilepsy is antiseizure drugs such as:

Drugs that affect voltage-dependent Na+ channels
- 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 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.^[1] ^[2]
- 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

↑ 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.