Novel approaches to anticonvulsant drug discovery.
BACKGROUND
The history of epilepsy dates back to 2000 BC. Yet, it was not until 1912 that the activity of the first antiepileptic, phenobarbital was discovered by accident. After this discovery, the next antiepileptic drugs to be discovered (phenytoin and primidone) were based on the phenobarbital's structure. Then, in 1960, carbamazepine was developed empirically, while in 1962, valproate demonstrated anticonvulsant activity against experimental seizures. The next antiepileptic drugs synthesized were either modifications of the existing drugs (such as oxcarbazepine and pregabalin) or completely novel chemical structures (lacosamide, perampanel and retigabine).


METHODS
The present paper briefly refers to the history of epilepsy and development of antiepileptic drugs. Further, the paper provides a discussion on the antiepileptogenic effects of antiepileptic drugs in terms of the constant percentage of epileptic patients with refractory seizures. The authors also review the likely factors involved in the false refractoriness (such as through the use of caffeine-containing beverages and smoking). Finally, the authors consider future directions in the search of novel antiepileptic drugs.


CONCLUSIONS
In spite of the considerable number of newer antiepileptic drugs, the number of drug-resistant epileptic patients remains unchanged. This may be rather an indication of the suitability of the currently available discovery procedures for effective antiepileptic drugs in the whole population of epileptic patients. The authors, however, believe that it is likely that models of mimic chronic epilepsy will help bridge the gaps and aid in the discovery of novel antiepileptic drugs - ones that can effectively modify the course of the disease.
Medical University, Department of Pathophysiology , Jaczewskiego 8, PL 20-090 Lublin , Poland +48 81 718 7365 ; +48 81 718 7364 ; czuczwarsj@yahoo.com.
Barbara
B
Miziak
Magdalena
M
Chrościńska-Krawczyk
Barbara
B
Błaszczyk
Iwona
I
Radzik
Stanisław J
SJ
Czuczwar
D000818:Animals; D000927:Anticonvulsants / Q000266:history / Q000494:pharmacology* / Q000627:therapeutic use*; D055808:Drug Discovery / Q000379:methods*; D018432:Drug Resistance, Multiple; D004827:Epilepsy / Q000188:drug therapy* / Q000266:history; D049668:History, 15th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049690:History, Ancient; D006801:Humans; D009410:Nerve Degeneration / Q000188:drug therapy
D000927:Anticonvulsants