Newer therapies in the drug treatment of epilepsy.
OBJECTIVE
To provide a review of recent developments in the pharmacotherapy of epilepsy.


METHODS
A MEDLINE search was performed to identify pertinent literature (1966-June 2001). Selected articles emphasized those published from 1997 to 2001. Bibliographies of identified articles were also evaluated.


METHODS
All identifiable sources written in English.


RESULTS
Epilepsy is a common neurologic disorder, and antiepileptic drugs (AEDs) are the mainstays of therapy. The focus of this article is on the 3 latest AEDs--levetiracetam, oxcarbazepine, and zonisamide. We discuss human data published as both original studies and reviews from the last 4 years, except where noted. We apply a general template for all 3 drugs and provide information on clinical trials, adverse effects, pharmacokinetics, drug interactions, and clinical use.


CONCLUSIONS
Levetiracetam, oxcarbazepine, and zonisamide are reasonable options for many patients whose seizures are not yet controlled or who suffer from intolerable adverse effects. All 3 agents are approved for adjunctive use in patients with partial seizures. Oxcarbazepine also has approval for monotherapy in partial seizures. All 3 drugs are well tolerated by most patients and have characteristics that potentially make them easier to use with medications other than the older AEDs. Further clinical experience is needed before specific recommendations can be given for their place among older and newer AEDs.
McAuley
James W
JW
College of Pharmacy, Ohio State University, 500 W. 12th Ave., Columbus, OH 43210-1291, USA. mcauley.5@osu.edu
Biederman
Toy S
TS
Smith
Jason C
JC
Moore
J Layne
JL
D000927:Anticonvulsants / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002220:Carbamazepine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004347:Drug Interactions; D004827:Epilepsy / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007555:Isoxazoles / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000077287:Levetiracetam; D000078330:Oxcarbazepine; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000078305:Zonisamide
D000927:Anticonvulsants; D007555:Isoxazoles; D002220:Carbamazepine; D000077287:Levetiracetam; D000078305:Zonisamide; D000078330:Oxcarbazepine; D010889:Piracetam