Clobazam, oxcarbazepine, tiagabine, topiramate, and other new antiepileptic drugs.
Clinical investigators recently have studied at least 21 new antiepileptic drugs (AEDs) in people with epilepsy. This review briefly examines 15 of these new AEDs: clobazam (CLB), dezinamide, flunarizine (FNR), loreclezole, milacemide (MLM), MK-801, nafimidone, ORG-6370, oxcarbazepine (OCBZ), progabide (PGB), ralitoline, stiripentol, tiagabine (TGB), topiramate (TPM), and zonisamide (ZNS). CLB, PGB, and TGB represent agents that act on the GABA system, and MLM acts on the glycine system. MK-801 and ZNS (in part) are excitatory amino acid antagonists, and FNR is a calcium-channel antagonist. OCBZ is a keto analogue of carbamazepine, which is not metabolized to the epoxide and may have fewer side effects. The remaining agents are novel compounds with a variety of suspected mechanisms. TPM appears especially effective for intractable partial seizures but has a high incidence of cognitive side effects. None of these new AEDs is useful for all patients with inadequate seizure control or ongoing toxicity. The role of each will require further clinical study and experience.
Fisher
R
R
Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013-4496, USA.
Blum
D
D
D000818:Animals; D014151:Anti-Anxiety Agents; D000927:Anticonvulsants / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001569:Benzodiazepines; D001570:Benzodiazepinones / Q000627:therapeutic use; D002220:Carbamazepine / Q000031:analogs & derivatives / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D000078306:Clobazam; D004195:Disease Models, Animal; D004827:Epilepsy / Q000188:drug therapy*; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D009557:Nipecotic Acids / Q000627:therapeutic use; D000078330:Oxcarbazepine; D051381:Rats; D000078308:Tiagabine; D000077236:Topiramate
D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D001570:Benzodiazepinones; D009557:Nipecotic Acids; D000077236:Topiramate; D001569:Benzodiazepines; D000078306:Clobazam; D005632:Fructose; D002220:Carbamazepine; D000078330:Oxcarbazepine; D000078308:Tiagabine