Drug selection for the newly diagnosed patient: when is a new generation antiepileptic drug indicated?

Journal of Neurology
Torbjörn Tomson

Abstract

Treatment options in epilepsy have increased dramatically since the early 1990s with the introduction of nine new generation antiepileptic drugs (AEDs) (felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, tiagabine, topiramate, vigabatrin and zonisamide). This makes drug selection much more complicated and challenging. This review discusses drug selection in patients with newly diagnosed epilepsy and in particular the role of new AEDs in this population. The choice of treatment should always be based on a careful comparison of the risk-benefit ratio for the different treatment options and the outcome of such evaluation may be different in patients with new onset compared with chronic epilepsy. Efficacy, tolerability and safety are the main criteria for selection of AEDs and any first line drug for patients with newly diagnosed epilepsy must have demonstrated satisfactory efficacy as monotherapy in that patient population. So far, of the new AEDs only lamotrigine, oxcarbazepine and topiramate have documentation sufficient to be granted licence for use as monotherapy in most European countries. Because the new generation AEDs have failed to demonstrate improved effectiveness as monotherapy, old generation AEDs such ...Continue Reading

Citations

Sep 9, 2005·Epilepsia·Arne ReimersEylert Brodtkorb
Nov 23, 2006·Epilepsia·Bernhard J Steinhoff
May 24, 2011·Pharmacological Reports : PR·Władysław LasońStanisław J Czuczwar
Nov 3, 2010·Acta Neurologica Scandinavica·J A CramerS Buyle
Jan 13, 2015·Brain & Development·Toshiyuki IwasakiMasahiro Ishii
Feb 3, 2007·Seizure : the Journal of the British Epilepsy Association·Steve ChungNicole Hank
Jan 14, 2009·Seizure : the Journal of the British Epilepsy Association·Helena GauffinBirgitta Söderfeldt
Jul 10, 2012·Epilepsy & Behavior : E&B·Ranjani ManjunathAlan B Ettinger
Jul 27, 2017·Epilepsia·Giorgia GiussaniUNKNOWN EPIRES Group
Nov 11, 2006·Clinical Neuropharmacology·Li-Ping ZouEilhard Mix
Apr 3, 2008·Clinical Neuropharmacology·Li-Ping ZouUNKNOWN Topiramate Study Group
Sep 30, 2005·Pediatric Rehabilitation·Frank S Pidcock
Apr 9, 2005·CNS Drugs·James E Frampton, Lesley J Scott

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.