title: New antiepileptic drugs: focus on ezogabine, clobazam, and perampanel.
abstract: Ezogabine, clobazam, and perampanel are among the newest antiseizure drugs approved by the Food and Drug Administration between 2011 and 2012. Ezogabine and perampanel are approved for adjunctive treatment of partial epilepsy. Perampanel is also approved for adjunctive treatment of primary generalized tonic-clonic seizures. Ezogabine and perampanel have novel mechanisms of action. Ezogabine binds to voltage-gated potassium channels and increases the M-current thereby causing membrane hyperpolarization. Perampanel is a selective, non-competitive 2-amino-3-(3-hydroxy-5-methyl-isoxazol-4-yl)propanoic acid receptor antagonist, which reduces neuronal excitation. Clobazam has been used worldwide since the 1970s and is approved for adjunctive treatment of seizures associated with Lennox-Gastaut syndrome. Clobazam is the only 1,5-benzodiazepine currently in clinical use, which is less sedating than the commonly used 1,4-benzodiazepines. Phase III multicenter, randomized, double-blind, placebo-controlled trials demonstrated efficacy and good tolerability of these 3 new antiepileptic drugs. These drugs represent a welcome addition to the armamentarium of practitioners, but it remains to be seen how they will affect the landscape of pharmacoresistant epilepsy.
authors.affiliation: Department of Neurology, University of Florida College of Medicine, Gainesville, Florida, USA.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Rudzinski
authors.affiliation: Department of Neurology, University of Miami, Miami, Florida, USA.
authors.forename: Naymeé J
authors.initials: NJ
authors.lastname: Vélez-Ruiz
authors.affiliation: Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Evan R
authors.initials: ER
authors.lastname: Gedzelman
authors.affiliation: Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Mauricio
authors.affiliation: Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA.
authors.forename: Jerry J
authors.initials: JJ
authors.lastname: Shih
authors.affiliation: Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Karakis
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D002219:Carbamates / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D000078306:Clobazam; D006801:Humans; D009570:Nitriles; D010655:Phenylenediamines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D011728:Pyridones / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D002219:Carbamates; D009570:Nitriles; D010655:Phenylenediamines; D011728:Pyridones; D001569:Benzodiazepines; C101866:ezogabine; D000078306:Clobazam; C551441:perampanel
keywords: Epilepsy