[Experimental basis for the treatment of drug-resistant epilepsy].
Drug-resistant epilepsy may result from an increased expression of protein transporters in the blood-brain barrier or close to an epileptic focus, negative changes in the structure of inhibitory receptors or ion channels or neurodegeneration. One of the existing therapeutic options is a combined treatment with antiepileptic drugs. It may be suggested that the selection of a proper antiepileptic drug combination should be based upon the preclinical data and first of all consider the drug combinations displaying synergy in a seizure test and antagonism or additivity in neurotoxicity tests. This condition (synergy in convulsive tests and antagonism in neurotoxicity tests) seems o be fulfilled by the following combinations: topiramate + lamotrigine, topiramate + oxcarbazepine or valproate + lamotrigine. Anticonvulsive synergy and neurotoxic additivity show: levetiracetam + carbamazepine (oxcarbazepine) or topiramate and tiagabine+gabapentin. In contrast, an evident antagonism has been found for lamotrigine + carbamazepine (or oxcarbazepine) in a seizure test. Considering experimental data from seizure and neurotoxicity tests may improve the therapy of drug-resistant epilepsy, especially that a combination of lamotrigine + carbamazepine is relatively frequently applied in epileptic patients.
Błaszczyk
Barbara
B
Oddział Neurologii, Wojewódzki Zespół Opieki Neuropsychiatrycznej, Kielce.
Trojnar
Marcin
M
Czuczwar
Stanisław J
SJ
D000741:Anemia, Aplastic / Q000139:chemically induced; D000818:Animals; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002986:Clinical Trials as Topic; D003072:Cognition Disorders / Q000139:chemically induced; D004347:Drug Interactions; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans; D008954:Models, Biological
D000927:Anticonvulsants