Novel anticonvulsant drugs.
Principles of complex mechanisms of action of anticonvulsants including latest reports concerning new antiepileptic drugs (AED) are considered. Different aspects of new anticonvulsant drugs (2nd generation) from preclinical and clinical testing, pharmacokinetics, and mono or combination therapy in children and adults are summarized. In the following condensed synopsis pharmacological and clinical characteristics of gabapentin (GBP), lamotrigine (LTG), levetiracetam (LEV), oxcarbazepine (OXC), pregabalin (PGB) and tiagabine (TGB) as well as topiramate (TPM) and zonisamide (ZNS) are discussed. In addition to the mechanisms of action, pharmacokinetics, interactions, indications and dosages as well as side effects are considered. Important data concerning the effect and tolerability of anticonvulsant drugs can be obtained from controlled studies. In comparison to drugs of the first generation (phenobarbital [PB], primidon [PRD], phenytoin [PHT], carbamazepine [CBZ] and valproic acid [VPA]) the potential for interactions and side effects due to enzyme induction or inhibition is reduced by most of the anticonvulsant drugs of the second generation. New anticonvulsant drugs increase the spectrum of treatment and represent further steps with regard to the optimization of an individual therapy of the epilepsies.
Stefan
H
H
University Clinic Erlangen, Epilepsy Center-Neurological Department, Schwabachanlage 6, D-91054 Erlangen, Germany.
Feuerstein
T J
TJ
D000588:Amines / Q000627:therapeutic use; D000818:Animals; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002220:Carbamazepine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D004827:Epilepsy / Q000188:drug therapy*; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D007555:Isoxazoles / Q000627:therapeutic use; D000077213:Lamotrigine; D000077287:Levetiracetam; D009557:Nipecotic Acids / Q000627:therapeutic use; D010889:Piracetam / Q000031:analogs & derivatives / Q000627:therapeutic use; D000069583:Pregabalin; D000078308:Tiagabine; D000077236:Topiramate; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use; D000078305:Zonisamide; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives / Q000627:therapeutic use
D000588:Amines; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D007555:Isoxazoles; D009557:Nipecotic Acids; D014227:Triazines; C476610:oxcarbamazepine; D000077236:Topiramate; D005632:Fructose; D002220:Carbamazepine; D000077287:Levetiracetam; D000078305:Zonisamide; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D000077213:Lamotrigine; D000078308:Tiagabine; D010889:Piracetam