[Gabapentin in the treatment of epilepsy in the elderly].
BACKGROUND
Epilepsy is the third most common neurological disease in the elderly. Diagnosis of epilepsy in this age is increasing because more people are reaching older age and physician awareness about this disorder is higher than in the past. Seizures are suspected in patients with episodic impairment of consciousness and neurological function, but in addition, seizures can be the cause of fluctuating cognitive derangement and nocturnal episodes of neurological dysfunction.


METHODS
The etiological spectrum of epilepsy in the elderly is different than in younger adults because of a higher prevalence of cerebrovascular disease and degenerative disorders of the central nervous system. The selection and dosage of antiepileptic drugs requires proper attention to special pharmacokinetic and pharmacodynamic situations that are common in older individuals. Changes that occur with advanced age are responsible of distinct pharmacokinetics, decreased tolerability to antiepileptic drugs, concomitant systemic diseases. In addition poor compliance and polypharmacy can complicate therapy.


CONCLUSIONS
Gabapentin has favourable pharmacokinetic properties: lack of hepatic metabolism, no protein binding, and easy to calculate regimen for patients with renal failure. For these reasons is a good candidate drug for treatment of seizures in the elderly.
Gil-Nagel
A
A
Servicio de Neurología, Programa de Epilepsia, Hospital Ruber Internacional, Madrid, 28034, España. agnagel@ya.com
D000085:Acetates / Q000627:therapeutic use*; D000273:Adipose Tissue / Q000378:metabolism; D000368:Aged; D000588:Amines; D000927:Anticonvulsants / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002561:Cerebrovascular Disorders / Q000150:complications; D003509:Cyclohexanecarboxylic Acids; D004827:Epilepsy / Q000188:drug therapy* / Q000209:etiology; D000077206:Gabapentin; D006304:Health Status; D006801:Humans; D007668:Kidney / Q000378:metabolism; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin