Antiepileptic Drugs

Abstract

We have found that in all types of epilepsy [except in focal epilepsy in children where a new drug (oxcarbamazepine) is considered to be the first choice for initial treatment], classic drugs (valproic acid in idiopathic generalized epilepsy and carbamazepine in focal epilepsy) are recommended as long as there are no contraindications due to adverse effects or concomitant use of other drugs that interact with the antiepileptics. However, despite the general recommendations, it can be deduced from the studies and reflections on the subject that the decision as to whether to start treatment or not, as well as the drug of choice, must be made on a case-by-case basis, taking into account the patient's personal and social circumstances.

Drug therapy of epileptic seizures among adult epileptic outpatients of University of Gondar Referral and Teaching Hospital, Gondar, North West Ethiopia

“…In addition to diagnostic difficulties, these people face different challenges of antiepileptic therapy, like inefficient and unevenly distributed health-care systems, cost of treatment, cultural attitude, economic problems, and qualitative and quantitative inadequacy of antiepileptic drugs 3,5–7. Even if a huge effort has been made for the development of new anti-epileptic drugs (AEDs) and improved formulations of older drugs, the AEDs we have today have limitations in their efficacy, safety, and convenience.…”

Recommendations for prescribing pharmacologic prevention during emergency department treatment of epileptic seizures

“…Las benzodiacepinas (BZD) son FACE con acción gabaérgica de interés en la primera línea de tratamiento en la fase aguda. Hay evidencia suficiente como para recomendar una BZD de manera precoz, no solo en crisis que persisten más de 1-2 minutos, sino tras resolución de CE tónico-clónicas o repetidas en acúmulos 1,4 . Su eficacia decae con el paso del tiempo tras la crisis 14 , por ello, no son prescritos usualmente en urgencias con carácter preventivo y por ende no se incluyen en este manuscrito.…”

“…Tras años de experiencia, se han notificado efectos adversos psiquiátricos que limitarían su empleo en determinados pacientes 21 . Se le considera el FACE de elección en los SU extrahospitalarios 4 .…”

“…"Tiempo es cerebro", también durante las crisis epilépticas, por lo que es necesario actuar con prontitud 3 . En un documento elaborado entre la Sociedad Española de Epilepsia (SEEP), de Neurología (SEN) y de Medicina de Urgencias y Emergencias (SEMES) en el que se ha definido el concepto de CE urgente, se ha consensuado el tratamiento en la fase aguda y se ha planteado un "código crisis" 4 . Se ha identificado que el estado epiléptico (EE) supone el 10% del total de CE atendidas en los SUH, describiéndose diferencias según el tipo de EE [5][6][7][8][9] .…”

Chronic valproic acid administration enhances oxidative stress, upregulates IL6 and downregulates Nrf2, Glut1 and Glut4 in rat’s liver and brain

“…Valproic acid (VPA) is an effective antiseizure drug which is commonly used for the treatment of various types of convulsions and neurological disorders [1,2]. The clinical use of VPA was associated with several complications such as hepatoxicity, obesity, hyperandrogenemia, hyperammonemia, hyperinsulinemia and impairment of brain glucose metabolism [3][4][5][6].…”