Epilepsy care: image of the future

Epilepsia
L Gram

Abstract

A number of factors have contributed to improvements in the care of epilepsy during the past decade, including the International League Against Epilepsy classifications, therapeutic antiepileptic drug (AED) monitoring and the concept of monotherapy, new AEDs with novel mechanisms of action, and new insights into etiology that suggest novel therapies. Pharmacologically "clean" AEDs acting on a single known mechanism will be an important element in the future care of patients with epilepsy. Augmentation of GABAergic inhibition is being successfully exploited by AEDs, and there remains much room for further pharmacologic innovation. The potential role of AEDs acting specifically on the GAT-1 or GAT-4 subgroup of gamma-aminobutyric acid transporters is a topic of current research. Specifically acting AEDs designed to have a single and known mode of action will permit true monotherapy, one AED with one target as opposed to one AED with several targets, and may open the way to rational polytherapy, i.e., designed use of one AED per mechanism in epilepsies with multifactorial causation. New research demonstrating a possible autoimmune basis for some forms of epilepsy illustrates the potential for novel nonpharmacologic approaches, and...Continue Reading

References

Jan 1, 1982·Progress in Neurobiology·A ChapmanJ C Vernieres
Apr 1, 1983·Epilepsia·M DamH R Angelo
Feb 1, 1983·Acta Neurologica Scandinavica·H R PetersenM Dam
Apr 1, 1995·Archives of Neurology·F E Dreifuss
Apr 21, 1995·Science·M Barinaga

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Citations

Oct 10, 2014·Expert Opinion on Drug Discovery·Juan C Garro MartinezMario R Estrada

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