title: Pharmacotherapy of the third-generation AEDs: lacosamide, retigabine and eslicarbazepine acetate.
abstract: BACKGROUND
  The search for new, more effective antiepileptic drugs (AEDs) continues. The three most recently approved drugs, the so-called third-generation AEDs, include lacosamide, retigabine and eslicarbazepine acetate and are licensed as adjunctive treatment of partial epilepsy in adults.
  
  
  METHODS
  For the above three AEDs, their mechanisms of action, pharmacokinetic characteristics, drug-drug interactions, pharmacotherapeutics, dose and administration and therapeutic drug monitoring are reviewed in this paper.
  
  
  CONCLUSIONS
  Lacosamide and retigabine act through novel mechanisms, while eslicarbazepine acetate, a pro-drug for eslicarbazepine, acts in a similar manner to several other AEDs. All three AEDs are associated with linear pharmacokinetic and rapid absorption and undergo metabolism. Their drug-drug interaction profile is low (lacosamide and retigabine) to modest (eslicarbazepine) in propensity. At the highest approved doses for the three AEDs, responder rates were similar. The most commonly observed adverse effects compared with placebo were dizziness, headache, diplopia and nausea for lacosamide; dizziness, somnolence and fatigue for retigabine and dizziness and somnolence for eslicarbazepine acetate. The precise role that these new AEDs will have in the treatment of epilepsy and whether they will make a significant impact on the prognosis of intractable epilepsy is not yet known and will have to await further clinical experience.
authors.affiliation: UCL-Institute of Neurology, Department of Clinical and Experimental Epilepsy, Pharmacology and Therapeutics Unit, Queen Square, London, WC1N 3BG, UK. P.Patsalos@ucl.ac.uk
authors.forename: Philip N
authors.initials: PN
authors.lastname: Patsalos
authors.forename: David J
authors.initials: DJ
authors.lastname: Berry
mesh_terms: D000081:Acetamides / Q000494:pharmacology / Q000627:therapeutic use; D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use*; D002219:Carbamates / Q000494:pharmacology / Q000627:therapeutic use; D003984:Dibenzazepines / Q000494:pharmacology / Q000627:therapeutic use; D004347:Drug Interactions; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans; D000078334:Lacosamide; D010655:Phenylenediamines / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000081:Acetamides; D000927:Anticonvulsants; D002219:Carbamates; D003984:Dibenzazepines; D010655:Phenylenediamines; C101866:ezogabine; D000078334:Lacosamide; C416835:eslicarbazepine acetate