Antiepileptic drugs and neuroprotection: current status and future roles.
There has been a growing interest in the use of antiepileptic drugs (AEDs) for neuroprotection, and in the possible role of AEDs in disease modification (i.e., antiepileptogenesis). Increased understanding of the mechanisms underlying brain injury has led to advances in the study of neuroprotection. However, defining the clinical paradigm and selecting appropriate outcomes to detect neuroprotective effects present challenges to clinicians studying the neuroprotective properties of drugs. Established AEDs, such as phenytoin, phenobarbital, and carbamazepine, have shown neuroprotective activity in an ischemic/hypoxic model of neuronal injury. Animal model studies also have suggested that newer AEDs, such as levetiracetam, topiramate, and zonisamide, may have neuroprotective or antiepileptogenic properties. However, the prevention of epileptogenesis by an AED has yet to be demonstrated in clinical trials. The future of neuroprotection may involve established and newer AEDs, as well as other compounds, such as immunophilins, caspase inhibitors, endocannabinoids, and antioxidants.
Willmore
L James
LJ
Department of Neurology, Saint Louis University School of Medicine, St. Louis, MO, USA. willmore@slu.edu
D000818:Animals; D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects; D004827:Epilepsy / Q000188:drug therapy; D005632:Fructose / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007555:Isoxazoles / Q000494:pharmacology / Q000627:therapeutic use; D000077213:Lamotrigine; D000077287:Levetiracetam; D018696:Neuroprotective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D010889:Piracetam / Q000031:analogs & derivatives / Q000494:pharmacology; D012640:Seizures / Q000188:drug therapy*; D000077236:Topiramate; D014227:Triazines / Q000494:pharmacology / Q000627:therapeutic use; D000078305:Zonisamide
D000927:Anticonvulsants; D007555:Isoxazoles; D018696:Neuroprotective Agents; D014227:Triazines; D000077236:Topiramate; D005632:Fructose; D000077287:Levetiracetam; D000078305:Zonisamide; D000077213:Lamotrigine; D010889:Piracetam