Epilepsy medical therapy
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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 in adult and children under 4 y/o.[3]
- The initial dosage is 400 mg/daily for adults.
- The maximum dosing is maintenance dose of 800 mg/daily.[4]
- The most common side effects of this drug are dizziness, drowsiness, nausea, headache, fatigue, vertigo, ataxia, diplopia, blurred vision, and tremor.[5]
- Lacosamide
- It can be used for treatment of focal-onset seizures in adult and children older than 4 y/o.[6]
- The initial dosage is 50 mg twice/daily as adjunctive therapy in adults and 100 mg twice per day as monotherapy .
- The maximum dosage is 200 to 400 mg per day. Children should be dosed according to body weight.[7]
- The most common side effects are Dizziness, nausea, vertigo, and ataxia.[8]
- Lamotrigine
- Oxcarbazepine
- It can be used for treatment of focal and secondarily generalized tonic-clonic seizures.[12]
- The initial dosage is 300 to 600 mg/day.
- The maximum dosage is 900 to 3000 mg/day.[13]
- The most common side effects are hyponatremia, sedation, headache, rash, dizziness, vertigo, ataxia, nausea, and diplopia.[14]
- 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.
- ↑ Perucca E, Yasothan U, Clincke G, Kirkpatrick P (December 2008). "Lacosamide". Nat Rev Drug Discov. 7 (12): 973–4. doi:10.1038/nrd2764. PMID 19043448.
- ↑ Ben-Menachem E, Biton V, Jatuzis D, Abou-Khalil B, Doty P, Rudd GD, Halász P, Kälviäinen R, Mazurkiewicz-Beldzińska M, Rosenow F, Doty P, Hebert D, Sullivan T (July 2007). "Efficacy and safety of oral lacosamide as adjunctive therapy in adults with partial-onset seizures". Epilepsia. 48 (7): 1308–17. doi:10.1111/j.1528-1167.2007.01188.x. PMID 17635557.
- ↑ Perucca E, Yasothan U, Clincke G, Kirkpatrick P (December 2008). "Lacosamide". Nat Rev Drug Discov. 7 (12): 973–4. doi:10.1038/nrd2764. PMID 19043448.
- ↑ French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, Theodore WH, Bazil C, Stern J, Schachter SC, Bergen D, Hirtz D, Montouris GD, Nespeca M, Gidal B, Marks WJ, Turk WR, Fischer JH, Bourgeois B, Wilner A, Faught RE, Sachdeo RC, Beydoun A, Glauser TA (April 2004). "Efficacy and tolerability of the new antiepileptic drugs I: treatment of new onset epilepsy: report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society". Neurology. 62 (8): 1252–60. PMID 15111659.
- ↑ Hirsch LJ, Weintraub D, Du Y, Buchsbaum R, Spencer HT, Hager M, Straka T, Bazil CW, Adams DJ, Resor SR, Morrell MJ (September 2004). "Correlating lamotrigine serum concentrations with tolerability in patients with epilepsy". Neurology. 63 (6): 1022–6. PMID 15452293.
- ↑ 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.
- ↑ Koch MW, Polman SK (October 2009). "Oxcarbazepine versus carbamazepine monotherapy for partial onset seizures". Cochrane Database Syst Rev (4): CD006453. doi:10.1002/14651858.CD006453.pub2. PMID 19821367.
- ↑ Kim DW, Gu N, Jang IJ, Chu K, Yu KS, Cho JY, Yoon SH, Kim HS, Oh J, Lee SK (January 2012). "Efficacy, tolerability, and pharmacokinetics of oxcarbazepine oral loading in patients with epilepsy". Epilepsia. 53 (1): e9–12. doi:10.1111/j.1528-1167.2011.03318.x. PMID 22091603.
- ↑ Buggy Y, Layton D, Fogg C, Shakir SA (May 2010). "Safety profile of oxcarbazepine: results from a prescription-event monitoring study". Epilepsia. 51 (5): 818–29. doi:10.1111/j.1528-1167.2009.02489.x. PMID 20132298.