New antiepileptic drugs in pediatric epilepsy.
New antiepileptic drugs (AEDs), introduced since 1993, provide more diverse options in the treatment of epilepsy. Despite the equivalent efficacy and better tolerability of these drugs, more than 25% of patients remain refractory to treatment. Moreover, the issues for pediatric patients are different from those for adults, and have not been addressed in the development and application of the new AEDs. Recently published evidence-based treatment guidelines have helped physicians to choose the most reasonable AED, although they cannot fully endorse new AEDs because of the lack of well-designed, randomized controlled trials. We review the mechanisms of action, pharmacokinetic properties, adverse reactions, efficacy, and tolerability of eight new AEDs (felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, topiramate, vigabatrin, and zonisamide), focusing on currently available treatment guidelines and expert opinions regarding pediatric epilepsy.
Hwang
Hee
H
Department of Pediatrics, Seoul National University Childern's Hospital, 28 Yongon-dong, Jongno-gu, Seoul 110-744, South Korea.
Kim
Ki Joong
KJ
D000588:Amines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D000927:Anticonvulsants / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002220:Carbamazepine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003509:Cyclohexanecarboxylic Acids / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D004827:Epilepsy / Q000188:drug therapy*; D000078328:Felbamate; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D000077213:Lamotrigine; D000077287:Levetiracetam; D010372:Pediatrics; D048448:Phenylcarbamates / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011409:Propylene Glycols / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D000077236:Topiramate; D014227:Triazines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D020888:Vigabatrin / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use
D000588:Amines; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D048448:Phenylcarbamates; D011409:Propylene Glycols; D014227:Triazines; C476610:oxcarbamazepine; D000077236:Topiramate; D005632:Fructose; D002220:Carbamazepine; D000077287:Levetiracetam; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D020888:Vigabatrin; D000077213:Lamotrigine; D000078328:Felbamate; D010889:Piracetam