Antiepileptic Drugs 2012: Recent Advances and Trends

Abstract

There are now 24 antiepileptic drugs (AEDs) approved for use in epilepsy in the United States by the Food and Drug Administration. A literature search was conducted using PubMed, MEDLINE, and Google for all English-language articles that discuss newly approved AEDs and the use of AEDs in epilepsy in the United States from January 1, 2008, through December 31, 2011. Five new agents were identified that have come onto the market within the past 2 years. Moreover, 3 trends involving AEDs have become clinically important and must be considered by all who treat patients with epilepsy. These trends include issues of generic substitution of AEDs, pharmacogenomics predicting serious adverse events in certain ethnic populations, and the issue of the suicide risk involving the entire class of AEDs. This article discusses the most recent AEDs approved for use in the United States and the 3 important trends shaping the modern medical management of epilepsy.

Rapid Throughput Analysis Demonstrates that Chemicals with Distinct Seizurogenic Mechanisms Differentially Alter Ca2+ Dynamics in Networks Formed by Hippocampal Neurons in Culture

“…Seizures can cause devastating damage to the brain, leading to cognitive impairment and increased risk of epilepsy (Reddy and Kuruba, 2013). Despite the availability of more than 20 antiepileptic drugs, around 30% of epilepsy patients experience refractory seizures or suffer from unacceptable drug side effects such as drowsiness, behavioral changes, memory impairment, or teratogenicity (Bialer and White, 2010;Sirven et al, 2012;Bialer et al, 2013).…”

Comparative animal study of the antinociceptive efficacy of lamotrigine and gabapentin for the management of pain

“…AEDs act by modifying the muscle or nerve excitability threshold, by controlling the ectopic firing and the chaotic neuronal discharge. Blocking voltage-gated Na and Ca channels, promoting GABA-A mediated inhibition, they counteract pain by inhibiting several electrophysiological changes that would make the cells fire from ectopic sites spontaneously and at inappropriately high frequencies (2,22,29). They have an important role in promoting the inhibition of abnormal neuronal activity and pain relief.…”

“…Co-analgesic medications include several groups of drugs, like antidepressant and anti-seizure drugs. They all have certain well-defined benefits, but we are still away from that one drug that would effectively control and treat different manifestations of chronic pain (29).…”

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“…Newer generation AEDs includes vigabatrin, felbamate, gabapentin, lamotrigine, tiagabine, topiramate, levetiracetam, oxcarbazepine, zonisamide, pregabalin, rufinamide and lacosamide. Newer generation AEDs exhibit both safety and improved tolerability when compared with older agents 8,9 .…”