Epilepsy medical therapy: Difference between revisions

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{{Epilepsy}}
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==Medical Therapy==
==Medical Therapy==
Pharmacologic medical therapies for epilepsy is anti-seizure drugs such as:
Pharmacologic medical therapies for epilepsy is anti-seizure drugs such as:
* Drugs that affect voltage-dependent Na+ channels
** Carbamazepin:
*** It can be used in treatment of both generalized and focal epilepsy.
*** The initial dose is 2-3 mg/kg per day divided into at least two time.
*** The maximum dosing is 10 mg/kg three-times-daily.
*** The most common side effects of this drug are GI disturbance, rash, hyponatremia and fluid retention.<ref name="pmid18981374">{{cite journal |vauthors=Hirsch LJ, Arif H, Nahm EA, Buchsbaum R, Resor SR, Bazil CW |title=Cross-sensitivity of skin rashes with antiepileptic drug use |journal=Neurology |volume=71 |issue=19 |pages=1527–34 |date=November 2008 |pmid=18981374 |doi=10.1212/01.wnl.0000334295.50403.4c |url=}}</ref> <ref name="pmid4207990">{{cite journal |vauthors=Cereghino JJ, Brock JT, Van Meter JC, Penry JK, Smith LD, White BG |title=Carbamazepine for epilepsy. A controlled prospective evaluation |journal=Neurology |volume=24 |issue=5 |pages=401–10 |date=May 1974 |pmid=4207990 |doi= |url=}}</ref>
** Eslicarbazepin
*** It can be used for treatment of focal-onset seizures in adult and children under 4 y/o.<ref name="pmid29067682">{{cite journal |vauthors=Chang XC, Yuan H, Wang Y, Xu HQ, Hong WK, Zheng RY |title=Eslicarbazepine acetate add-on for drug-resistant partial epilepsy |journal=Cochrane Database Syst Rev |volume=10 |issue= |pages=CD008907 |date=October 2017 |pmid=29067682 |doi=10.1002/14651858.CD008907.pub3 |url=}}</ref>
*** The initial dosage is 400 mg/daily for adults.
*** The maximum dosing is maintenance dose of 800 mg/daily.<ref name="pmid18508949">{{cite journal |vauthors=Almeida L, Minciu I, Nunes T, Butoianu N, Falcão A, Magureanu SA, Soares-da-Silva P |title=Pharmacokinetics, efficacy, and tolerability of eslicarbazepine acetate in children and adolescents with epilepsy |journal=J Clin Pharmacol |volume=48 |issue=8 |pages=966–77 |date=August 2008 |pmid=18508949 |doi=10.1177/0091270008319706 |url=}}</ref>
*** The most common side effects of this drug are dizziness, drowsiness, nausea, headache, fatigue, vertigo, ataxia, diplopia, blurred vision, and tremor.<ref name="pmid25528898">{{cite journal |vauthors=Sperling MR, Abou-Khalil B, Harvey J, Rogin JB, Biraben A, Galimberti CA, Kowacs PA, Hong SB, Cheng H, Blum D, Nunes T, Soares-da-Silva P |title=Eslicarbazepine acetate as adjunctive therapy in patients with uncontrolled partial-onset seizures: Results of a phase III, double-blind, randomized, placebo-controlled trial |journal=Epilepsia |volume=56 |issue=2 |pages=244–53 |date=February 2015 |pmid=25528898 |pmc=4354260 |doi=10.1111/epi.12894 |url=}}</ref>
** Lacosamide
*** It can be used for treatment of focal-onset seizures in adult and children older than 4 y/o.<ref name="pmid19043448">{{cite journal |vauthors=Perucca E, Yasothan U, Clincke G, Kirkpatrick P |title=Lacosamide |journal=Nat Rev Drug Discov |volume=7 |issue=12 |pages=973–4 |date=December 2008 |pmid=19043448 |doi=10.1038/nrd2764 |url=}}</ref>
*** The initial dosage is 50 mg twice/daily as adjunctive therapy in adults and 100 mg twice per day as monotherapy  .
*** The maximum dosage is 200 to 400 mg per day. Children should be dosed according to body weight.<ref name="pmid17635557">{{cite journal |vauthors=Ben-Menachem E, Biton V, Jatuzis D, Abou-Khalil B, Doty P, Rudd GD, Halász P, Kälviäinen R, Mazurkiewicz-Beldzińska M, Rosenow F, Doty P, Hebert D, Sullivan T |title=Efficacy and safety of oral lacosamide as adjunctive therapy in adults with partial-onset seizures |journal=Epilepsia |volume=48 |issue=7 |pages=1308–17 |date=July 2007 |pmid=17635557 |doi=10.1111/j.1528-1167.2007.01188.x |url=}}</ref>
*** The most common side effects are Dizziness, nausea, vertigo, and ataxia.<ref name="pmid190434482">{{cite journal |vauthors=Perucca E, Yasothan U, Clincke G, Kirkpatrick P |title=Lacosamide |journal=Nat Rev Drug Discov |volume=7 |issue=12 |pages=973–4 |date=December 2008 |pmid=19043448 |doi=10.1038/nrd2764 |url=}}</ref>
** Lamotrigine
*** It can be used for adjunctive treatment for primary generalized tonic-clonic seizures and focal seizures in adults and children under two y/o.<ref name="pmid15111659">{{cite journal |vauthors=French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, Theodore WH, Bazil C, Stern J, Schachter SC, Bergen D, Hirtz D, Montouris GD, Nespeca M, Gidal B, Marks WJ, Turk WR, Fischer JH, Bourgeois B, Wilner A, Faught RE, Sachdeo RC, Beydoun A, Glauser TA |title=Efficacy and tolerability of the new antiepileptic drugs I: treatment of new onset epilepsy: report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society |journal=Neurology |volume=62 |issue=8 |pages=1252–60 |date=April 2004 |pmid=15111659 |doi= |url=}}</ref>
*** The initial dosage is 25 mg/daily.
*** The maximum dosage is 225 to 375 mg/daily<ref name="pmid15452293">{{cite journal |vauthors=Hirsch LJ, Weintraub D, Du Y, Buchsbaum R, Spencer HT, Hager M, Straka T, Bazil CW, Adams DJ, Resor SR, Morrell MJ |title=Correlating lamotrigine serum concentrations with tolerability in patients with epilepsy |journal=Neurology |volume=63 |issue=6 |pages=1022–6 |date=September 2004 |pmid=15452293 |doi= |url=}}</ref>
*** The most common side effects are rash and nausea.<ref name="pmid189813742">{{cite journal |vauthors=Hirsch LJ, Arif H, Nahm EA, Buchsbaum R, Resor SR, Bazil CW |title=Cross-sensitivity of skin rashes with antiepileptic drug use |journal=Neurology |volume=71 |issue=19 |pages=1527–34 |date=November 2008 |pmid=18981374 |doi=10.1212/01.wnl.0000334295.50403.4c |url=}}</ref>
** Oxcarbazepine
*** It can be used for treatment of focal and secondarily generalized tonic-clonic seizures.<ref name="pmid19821367">{{cite journal |vauthors=Koch MW, Polman SK |title=Oxcarbazepine versus carbamazepine monotherapy for partial onset seizures |journal=Cochrane Database Syst Rev |volume= |issue=4 |pages=CD006453 |date=October 2009 |pmid=19821367 |doi=10.1002/14651858.CD006453.pub2 |url=}}</ref>
*** The initial dosage is 300 to 600 mg/day.
*** The maximum dosage is 900 to 3000 mg/day.<ref name="pmid22091603">{{cite journal |vauthors=Kim DW, Gu N, Jang IJ, Chu K, Yu KS, Cho JY, Yoon SH, Kim HS, Oh J, Lee SK |title=Efficacy, tolerability, and pharmacokinetics of oxcarbazepine oral loading in patients with epilepsy |journal=Epilepsia |volume=53 |issue=1 |pages=e9–12 |date=January 2012 |pmid=22091603 |doi=10.1111/j.1528-1167.2011.03318.x |url=}}</ref>
*** The most common side effects are hyponatremia, sedation, headache, rash, dizziness, vertigo, ataxia, nausea, and diplopia.<ref name="pmid20132298">{{cite journal |vauthors=Buggy Y, Layton D, Fogg C, Shakir SA |title=Safety profile of oxcarbazepine: results from a prescription-event monitoring study |journal=Epilepsia |volume=51 |issue=5 |pages=818–29 |date=May 2010 |pmid=20132298 |doi=10.1111/j.1528-1167.2009.02489.x |url=}}</ref>
** Phenytoin
*** It can be used for treatment of focal/generalized seizures and status epilepticus.<ref name="pmid2428283">{{cite journal |vauthors=Yaari Y, Selzer ME, Pincus JH |title=Phenytoin: mechanisms of its anticonvulsant action |journal=Ann. Neurol. |volume=20 |issue=2 |pages=171–84 |date=August 1986 |pmid=2428283 |doi=10.1002/ana.410200202 |url=}}</ref>
*** The initial dosage is 15 mg/kg/day in three doses.<ref name="pmid25099164">{{cite journal |vauthors=Caudle KE, Rettie AE, Whirl-Carrillo M, Smith LH, Mintzer S, Lee MT, Klein TE, Callaghan JT |title=Clinical pharmacogenetics implementation consortium guidelines for CYP2C9 and HLA-B genotypes and phenytoin dosing |journal=Clin. Pharmacol. Ther. |volume=96 |issue=5 |pages=542–8 |date=November 2014 |pmid=25099164 |doi=10.1038/clpt.2014.159 |url=}}</ref>
*** The most common side effects are gingival hypertrophy, hirsutism, rash, folic acid depletion, and decreased bone density.<ref name="pmid6424397">{{cite journal |vauthors=Iivanainen M, Savolainen H |title=Side effects of phenobarbital and phenytoin during long-term treatment of epilepsy |journal=Acta Neurol. Scand., Suppl. |volume=97 |issue= |pages=49–67 |date=1983 |pmid=6424397 |doi= |url=}}</ref>
** Rufinamide
*** It can be used for adjunctive treatment of seizures associated with Lennos-gastaut syndrome (LGS).<ref name="pmid18401024">{{cite journal |vauthors=Glauser T, Kluger G, Sachdeo R, Krauss G, Perdomo C, Arroyo S |title=Rufinamide for generalized seizures associated with Lennox-Gastaut syndrome |journal=Neurology |volume=70 |issue=21 |pages=1950–8 |date=May 2008 |pmid=18401024 |doi=10.1212/01.wnl.0000303813.95800.0d |url=}}</ref>
*** The initial dosage In children is 10 mg/kg per day in two divided doses and in adults is 400 to 800 mg per day in two divided doses.
*** The maximum dosage in children is 45 mg/kg per day or 3200 mg/day and in adults is 3200 mg/day.<ref name="pmid20084538">{{cite journal |vauthors=Marchand M, Fuseau E, Critchley DJ |title=Supporting the recommended paediatric dosing regimen for rufinamide in Lennox-Gastaut syndrome using clinical trial simulation |journal=J Pharmacokinet Pharmacodyn |volume=37 |issue=1 |pages=99–118 |date=February 2010 |pmid=20084538 |doi=10.1007/s10928-009-9146-4 |url=}}</ref>
*** The most common side effects are drowsiness and vomiting.<ref name="pmid20126329">{{cite journal |vauthors=Wheless JW, Vazquez B |title=Rufinamide: a novel broad-spectrum antiepileptic drug |journal=Epilepsy Curr |volume=10 |issue=1 |pages=1–6 |date=January 2010 |pmid=20126329 |pmc=2812713 |doi=10.1111/j.1535-7511.2009.01336.x |url=}}</ref>
** Zonisamide
*** It can be used for treatment of focal and generalized seizures in both adults and children.<ref name="pmid23837461">{{cite journal |vauthors=Guerrini R, Rosati A, Segieth J, Pellacani S, Bradshaw K, Giorgi L |title=A randomized phase III trial of adjunctive zonisamide in pediatric patients with partial epilepsy |journal=Epilepsia |volume=54 |issue=8 |pages=1473–80 |date=August 2013 |pmid=23837461 |doi=10.1111/epi.12233 |url=}}</ref>
*** The initial dosage is 100 to 200 mg/daily in two divided doses.
*** The maximum dosage is 400 to 600 mg/daily.<ref name="pmid15511691">{{cite journal |vauthors=Leppik IE |title=Zonisamide: chemistry, mechanism of action, and pharmacokinetics |journal=Seizure |volume=13 Suppl 1 |issue= |pages=S5–9; discussion S10 |date=December 2004 |pmid=15511691 |doi=10.1016/j.seizure.2004.04.016 |url=}}</ref>
*** The most common side effects are drowsiness, anxiety, ataxia, anorexia, confusion, abnormal thinking, fatigue, dizziness and decreased sweating and fever in children. <ref name="pmid17945539">{{cite journal |vauthors=Park SP, Hwang YH, Lee HW, Suh CK, Kwon SH, Lee BI |title=Long-term cognitive and mood effects of zonisamide monotherapy in epilepsy patients |journal=Epilepsy Behav |volume=12 |issue=1 |pages=102–8 |date=January 2008 |pmid=17945539 |doi=10.1016/j.yebeh.2007.08.002 |url=}}</ref>
* Drugs that affect Ca currents
** Ethosuximide
*** It can be used for treatment of absence seizures.
*** The initial dosage is 20 to 40 mg/kg/day.
*** The maximum serum level is 40 to 100 mcg/mL (280 to 700 micromol/L).
*** The most common side effects are nausea and vomiting, sleep disorders and somnolence.<ref name="pmid20200383">{{cite journal |vauthors=Glauser TA, Cnaan A, Shinnar S, Hirtz DG, Dlugos D, Masur D, Clark PO, Capparelli EV, Adamson PC |title=Ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy |journal=N. Engl. J. Med. |volume=362 |issue=9 |pages=790–9 |date=March 2010 |pmid=20200383 |pmc=2924476 |doi=10.1056/NEJMoa0902014 |url=}}</ref>
* Drugs that affect GABA activity
** Benzodiazepines
*** It can be used for adjunctive therapy for myoclonic/atonic seizures and focal/generalized tonic-clonic seizures.
*** The most common side effects are anterograde amnesia, drowsiness and increased risk of falling in elderly persons.<ref name="pmid20305598">{{cite journal |vauthors=Uzun S, Kozumplik O, Jakovljević M, Sedić B |title=Side effects of treatment with benzodiazepines |journal=Psychiatr Danub |volume=22 |issue=1 |pages=90–3 |date=March 2010 |pmid=20305598 |doi= |url=}}</ref>
** Phenobarbital
*** It can be used for treatment of generalized and focal seizures.
*** The initial dosage is 1 to 5 mg/kg per day.
*** The goal therapeutic level is 10 to 40 mcg/mL (43 to 172 micromol/L).<ref name="urlapps.who.int">{{cite web |url=http://apps.who.int/iris/bitstream/handle/10665/61822/WHO_MNH_MND_90.3.pdf?sequence=1&isAllowed=y |title=apps.who.int |format= |work= |accessdate=}}</ref>
*** The most common side effects are sleep disturbance and daytime irritability.<ref name="pmid381616">{{cite journal |vauthors=Camfield CS, Chaplin S, Doyle AB, Shapiro SH, Cummings C, Camfield PR |title=Side effects of phenobarbital in toddlers; behavioral and cognitive aspects |journal=J. Pediatr. |volume=95 |issue=3 |pages=361–5 |date=September 1979 |pmid=381616 |doi= |url=}}</ref>
** Tiagabine
*** It can be used for adjunctive treatment for focal seizures.<ref name="pmid151116592">{{cite journal |vauthors=French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, Theodore WH, Bazil C, Stern J, Schachter SC, Bergen D, Hirtz D, Montouris GD, Nespeca M, Gidal B, Marks WJ, Turk WR, Fischer JH, Bourgeois B, Wilner A, Faught RE, Sachdeo RC, Beydoun A, Glauser TA |title=Efficacy and tolerability of the new antiepileptic drugs I: treatment of new onset epilepsy: report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society |journal=Neurology |volume=62 |issue=8 |pages=1252–60 |date=April 2004 |pmid=15111659 |doi= |url=}}</ref>
*** The initial dosage is 4 to 8 mg/day.
*** The most common side effects are dizziness, somnolence, anxiety, tremor, difficulty concentrating, nausea and abdominal pain.<ref name="pmid22592677">{{cite journal |vauthors=Pulman J, Marson AG, Hutton JL, French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, Theodore WH, Bazil C, Stern J, Schachter SC, Bergen D, Hirtz D, Montouris GD, Nespeca M, Gidal B, Marks WJ, Turk WR, Fischer JH, Bourgeois B, Wilner A, Faught RE, Sachdeo RC, Beydoun A, Glauser TA |title=Tiagabine add-on for drug-resistant partial epilepsy |journal=Cochrane Database Syst Rev |volume=62 |issue=5 |pages=CD001908 |date=May 2012 |pmid=22592677 |pmc=4058679 |doi=10.1002/14651858.CD001908.pub2 |url=}}</ref>
** Vigabatrin
*** It can be used for add-on treatment for refractory focal seizures.<ref name="pmid23440814">{{cite journal |vauthors=Hemming K, Maguire MJ, Hutton JL, Marson AG |title=Vigabatrin for refractory partial epilepsy |journal=Cochrane Database Syst Rev |volume= |issue=1 |pages=CD007302 |date=January 2013 |pmid=23440814 |doi=10.1002/14651858.CD007302.pub2 |url=}}</ref>
*** The initial dosage is 500 mg/day.
*** The maximum dosage is 3 gr/day.<ref name="pmid20208475">{{cite journal |vauthors= |title=Vigabatrin (Sabril) for epilepsy |journal=Med Lett Drugs Ther |volume=52 |issue=1332 |pages=14–6; quiz 17 |date=February 2010 |pmid=20208475 |doi= |url=}}</ref>
*** The most common side effects are  visual loss, drowsiness, fatigue, headache, and dizziness.<ref name="pmid10406359">{{cite journal |vauthors=Chadwick D |title=Safety and efficacy of vigabatrin and carbamazepine in newly diagnosed epilepsy: a multicentre randomised double-blind study. Vigabatrin European Monotherapy Study Group |journal=Lancet |volume=354 |issue=9172 |pages=13–9 |date=July 1999 |pmid=10406359 |doi= |url=}}</ref>
* Drugs that affect glutamate receptor
** Perampanel
*** It can be used for treatment of focal-onset seizures  in patients older than 12 y/o and as adjunctive treatment for primary generalized tonic-clonic seizures.<ref name="urlDrugs@FDA: FDA Approved Drug Products">{{cite web |url=http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm |title=Drugs@FDA: FDA Approved Drug Products |format= |work= |accessdate=}}</ref>
*** The initial dosage is 2 mg/day.
*** The maximum dose is 12 mg/day.<ref name="pmid25461214">{{cite journal |vauthors=Coyle H, Clough P, Cooper P, Mohanraj R |title=Clinical experience with perampanel: focus on psychiatric adverse effects |journal=Epilepsy Behav |volume=41 |issue= |pages=193–6 |date=December 2014 |pmid=25461214 |doi=10.1016/j.yebeh.2014.09.072 |url=}}</ref>
*** The most common side effects are dizziness, drowsiness, headache, fatigue, irritability, ataxia, nausea, and weight gain.<ref name="pmid22843280">{{cite journal |vauthors=French JA, Krauss GL, Biton V, Squillacote D, Yang H, Laurenza A, Kumar D, Rogawski MA |title=Adjunctive perampanel for refractory partial-onset seizures: randomized phase III study 304 |journal=Neurology |volume=79 |issue=6 |pages=589–96 |date=August 2012 |pmid=22843280 |pmc=3413761 |doi=10.1212/WNL.0b013e3182635735 |url=}}</ref>
* Drugs with multiple mechanisms of action
** Felbamate
*** It can be used for treatment of focal seizures and Lennox-Gastaut syndrome (LGS).<ref name="pmid8039474">{{cite journal |vauthors=Bourgeois BF |title=Felbamate in the treatment of partial-onset seizures |journal=Epilepsia |volume=35 Suppl 5 |issue= |pages=S58–61 |date=1994 |pmid=8039474 |doi= |url=}}</ref>
*** This drug can cause fatal aplastic anemia and hepatic failure.<ref name="pmid8628501">{{cite journal |vauthors=O'Neil MG, Perdun CS, Wilson MB, McGown ST, Patel S |title=Felbamate-associated fatal acute hepatic necrosis |journal=Neurology |volume=46 |issue=5 |pages=1457–9 |date=May 1996 |pmid=8628501 |doi= |url=}}</ref>
** Topiramate
*** It can be used for treatment of focal seizures in adults and children older than two y/o.<ref name="pmid24570033">{{cite journal |vauthors=Pulman J, Jette N, Dykeman J, Hemming K, Hutton JL, Marson AG |title=Topiramate add-on for drug-resistant partial epilepsy |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD001417 |date=February 2014 |pmid=24570033 |doi=10.1002/14651858.CD001417.pub3 |url=}}</ref>
*** The initial dosage is 50 mg/day.<ref name="pmid20633037">{{cite journal |vauthors=Ramsay E, Faught E, Krumholz A, Naritoku D, Privitera M, Schwarzman L, Mao L, Wiegand F, Hulihan J |title=Efficacy, tolerability, and safety of rapid initiation of topiramate versus phenytoin in patients with new-onset epilepsy: a randomized double-blind clinical trial |journal=Epilepsia |volume=51 |issue=10 |pages=1970–7 |date=October 2010 |pmid=20633037 |doi=10.1111/j.1528-1167.2010.02670.x |url=}}</ref>
*** The most common side effects are Weight loss, paresthesias, drowsiness, dizziness, depression, headache, cognition and language impairment.<ref name="pmid15857429">{{cite journal |vauthors=Majkowski J, Neto W, Wapenaar R, Van Oene J |title=Time course of adverse events in patients with localization-related epilepsy receiving topiramate added to carbamazepine |journal=Epilepsia |volume=46 |issue=5 |pages=648–53 |date=May 2005 |pmid=15857429 |doi=10.1111/j.1528-1167.2005.35904.x |url=}}</ref>
** Valporate
*** It can be used for treatment of generalized and focal seizures.
*** The initial dosage is 10 to 15 mg/kg per day.<ref name="pmid6425050">{{cite journal |vauthors=Loiseau P |title=Rational use of valproate: indications and drug regimen in epilepsy |journal=Epilepsia |volume=25 Suppl 1 |issue= |pages=S65–72 |date=1984 |pmid=6425050 |doi= |url=}}</ref>
*** The most common side effects are nausea, vomiting, hair loss, easy bruising, ]tremor, weight gain, obesity, insulin resistance, metabolic syndrome, thrombocytopenia and other coagulation disturbances, subclinical hypothyroidism, polycystic ovarian syndrome, fanconi syndrome.<ref name="pmid11160951">{{cite journal |vauthors=Biton V, Mirza W, Montouris G, Vuong A, Hammer AE, Barrett PS |title=Weight change associated with valproate and lamotrigine monotherapy in patients with epilepsy |journal=Neurology |volume=56 |issue=2 |pages=172–7 |date=January 2001 |pmid=11160951 |doi= |url=}}</ref><ref name="pmid20304335">{{cite journal |vauthors=Endo A, Fujita Y, Fuchigami T, Takahashi S, Mugishima H |title=Fanconi syndrome caused by valproic acid |journal=Pediatr. Neurol. |volume=42 |issue=4 |pages=287–90 |date=April 2010 |pmid=20304335 |doi=10.1016/j.pediatrneurol.2009.12.003 |url=}}</ref><ref name="pmid16886976">{{cite journal |vauthors=Gerstner T, Teich M, Bell N, Longin E, Dempfle CE, Brand J, König S |title=Valproate-associated coagulopathies are frequent and variable in children |journal=Epilepsia |volume=47 |issue=7 |pages=1136–43 |date=July 2006 |pmid=16886976 |doi=10.1111/j.1528-1167.2006.00587.x |url=}}</ref><ref name="pmid18503558">{{cite journal |vauthors=Sahota P, Prabhakar S, Kharbanda PS, Bhansali A, Jain V, Das CP, Modi M |title=Seizure type, antiepileptic drugs, and reproductive endocrine dysfunction in Indian women with epilepsy: a cross-sectional study |journal=Epilepsia |volume=49 |issue=12 |pages=2069–77 |date=December 2008 |pmid=18503558 |doi=10.1111/j.1528-1167.2008.01676.x |url=}}</ref><ref name="pmid21824562">{{cite journal |vauthors=Aggarwal A, Rastogi N, Mittal H, Chillar N, Patil R |title=Thyroid hormone levels in children receiving carbamazepine or valproate |journal=Pediatr. Neurol. |volume=45 |issue=3 |pages=159–62 |date=September 2011 |pmid=21824562 |doi=10.1016/j.pediatrneurol.2011.04.005 |url=}}</ref>
* Drugs with other mechanisms of action
** Brivaracetam
*** It can be used for treatment of focal-onset seizures and generalized epilepsy.<ref name="pmid26471380">{{cite journal |vauthors=Klein P, Schiemann J, Sperling MR, Whitesides J, Liang W, Stalvey T, Brandt C, Kwan P |title=A randomized, double-blind, placebo-controlled, multicenter, parallel-group study to evaluate the efficacy and safety of adjunctive brivaracetam in adult patients with uncontrolled partial-onset seizures |journal=Epilepsia |volume=56 |issue=12 |pages=1890–8 |date=December 2015 |pmid=26471380 |doi=10.1111/epi.13212 |url=}}</ref><ref name="pmid264713803">{{cite journal |vauthors=Klein P, Schiemann J, Sperling MR, Whitesides J, Liang W, Stalvey T, Brandt C, Kwan P |title=A randomized, double-blind, placebo-controlled, multicenter, parallel-group study to evaluate the efficacy and safety of adjunctive brivaracetam in adult patients with uncontrolled partial-onset seizures |journal=Epilepsia |volume=56 |issue=12 |pages=1890–8 |date=December 2015 |pmid=26471380 |doi=10.1111/epi.13212 |url=}}</ref>
*** The initial dosage is 50 mg twice daily.<ref name="urlDrugs@FDA: FDA Approved Drug Products2">{{cite web |url=http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Overview&DrugName=BRIVIACT |title=Drugs@FDA: FDA Approved Drug Products |format= |work= |accessdate=}}</ref>
*** The most common side effects are irritability, anxiety, insomnia and depression.<ref name="pmid264713802">{{cite journal |vauthors=Klein P, Schiemann J, Sperling MR, Whitesides J, Liang W, Stalvey T, Brandt C, Kwan P |title=A randomized, double-blind, placebo-controlled, multicenter, parallel-group study to evaluate the efficacy and safety of adjunctive brivaracetam in adult patients with uncontrolled partial-onset seizures |journal=Epilepsia |volume=56 |issue=12 |pages=1890–8 |date=December 2015 |pmid=26471380 |doi=10.1111/epi.13212 |url=}}</ref>
** Gabapentin
*** It can be used for treatment of refractory focal seizures.<ref name="pmid15111660">{{cite journal |vauthors=French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, Theodore WH, Bazil C, Stern J, Schachter SC, Bergen D, Hirtz D, Montouris GD, Nespeca M, Gidal B, Marks WJ, Turk WR, Fischer JH, Bourgeois B, Wilner A, Faught RE, Sachdeo RC, Beydoun A, Glauser TA |title=Efficacy and tolerability of the new antiepileptic drugs II: treatment of refractory epilepsy: report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society |journal=Neurology |volume=62 |issue=8 |pages=1261–73 |date=April 2004 |pmid=15111660 |doi= |url=}}</ref>
*** The initial dosage is 300 mg three times daily.
*** The maximum dosage is 2400 mg/day.<ref name="pmid23888424">{{cite journal |vauthors=Al-Bachari S, Pulman J, Hutton JL, Marson AG |title=Gabapentin add-on for drug-resistant partial epilepsy |journal=Cochrane Database Syst Rev |volume= |issue=7 |pages=CD001415 |date=July 2013 |pmid=23888424 |doi=10.1002/14651858.CD001415.pub2 |url=}}</ref>
*** The most common side effects are sedation, dizziness, ataxia and weight gain.<ref name="pmid27265421">{{cite journal |vauthors=Smith RV, Havens JR, Walsh SL |title=Gabapentin misuse, abuse and diversion: a systematic review |journal=Addiction |volume=111 |issue=7 |pages=1160–74 |date=July 2016 |pmid=27265421 |pmc=5573873 |doi=10.1111/add.13324 |url=}}</ref>
** Levetiracetam
*** It can be used for adjunctive  treatment of focal-onset seizures, myoclonic seizures in patients older than 12 y/o with juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures in patients older than six y/o with idiopathic generalized epilepsy.<ref name="pmid17625106">{{cite journal |vauthors=Berkovic SF, Knowlton RC, Leroy RF, Schiemann J, Falter U |title=Placebo-controlled study of levetiracetam in idiopathic generalized epilepsy |journal=Neurology |volume=69 |issue=18 |pages=1751–60 |date=October 2007 |pmid=17625106 |doi=10.1212/01.wnl.0000268699.34614.d3 |url=}}</ref><ref name="pmid22972056">{{cite journal |vauthors=Mbizvo GK, Dixon P, Hutton JL, Marson AG |title=Levetiracetam add-on for drug-resistant focal epilepsy: an updated Cochrane Review |journal=Cochrane Database Syst Rev |volume= |issue=9 |pages=CD001901 |date=September 2012 |pmid=22972056 |doi=10.1002/14651858.CD001901.pub2 |url=}}</ref><ref name="pmid22050371">{{cite journal |vauthors=Delanty N, Jones J, Tonner F |title=Adjunctive levetiracetam in children, adolescents, and adults with primary generalized seizures: open-label, noncomparative, multicenter, long-term follow-up study |journal=Epilepsia |volume=53 |issue=1 |pages=111–9 |date=January 2012 |pmid=22050371 |doi=10.1111/j.1528-1167.2011.03300.x |url=}}</ref>
*** The initial dosage is 500 mg twice daily.
*** The maximum dosage is 4000 mg daily.
*** The most common side effects are
** Pregabalin
*** It can be used for treatment of
*** The initial dosage is
*** The most common side effects are


=== Drugs that affect voltage-dependent Na+ channels ===
* [[Carbamazepine]]:
** It can be used in treatment of both [[Generalised epilepsy|generalized]] and [[Focal Epilepsy|focal epilepsy]].
** The initial dose is 2-3 mg/kg per day divided into at least two time.
** The maximum dosing is 10 mg/kg three-times-daily.
** The most common [[side effects]] of this drug are [[Gastrointestinal tract|GI]] disturbance, [[rash]], [[hyponatremia]] and [[fluid retention]].<ref name="pmid18981374">{{cite journal |vauthors=Hirsch LJ, Arif H, Nahm EA, Buchsbaum R, Resor SR, Bazil CW |title=Cross-sensitivity of skin rashes with antiepileptic drug use |journal=Neurology |volume=71 |issue=19 |pages=1527–34 |date=November 2008 |pmid=18981374 |doi=10.1212/01.wnl.0000334295.50403.4c |url=}}</ref> <ref name="pmid4207990">{{cite journal |vauthors=Cereghino JJ, Brock JT, Van Meter JC, Penry JK, Smith LD, White BG |title=Carbamazepine for epilepsy. A controlled prospective evaluation |journal=Neurology |volume=24 |issue=5 |pages=401–10 |date=May 1974 |pmid=4207990 |doi= |url=}}</ref>
* [[Eslicarbazepine|Eslicarbazepin]]
** It can be used for treatment of [[Focal seizures|focal-onset seizures]] in adult and children under 4 y/o.<ref name="pmid29067682">{{cite journal |vauthors=Chang XC, Yuan H, Wang Y, Xu HQ, Hong WK, Zheng RY |title=Eslicarbazepine acetate add-on for drug-resistant partial epilepsy |journal=Cochrane Database Syst Rev |volume=10 |issue= |pages=CD008907 |date=October 2017 |pmid=29067682 |doi=10.1002/14651858.CD008907.pub3 |url=}}</ref>
** The initial dosage is 400 mg/daily for adults.
** The maximum dosing is maintenance dose of 800 mg/daily.<ref name="pmid18508949">{{cite journal |vauthors=Almeida L, Minciu I, Nunes T, Butoianu N, Falcão A, Magureanu SA, Soares-da-Silva P |title=Pharmacokinetics, efficacy, and tolerability of eslicarbazepine acetate in children and adolescents with epilepsy |journal=J Clin Pharmacol |volume=48 |issue=8 |pages=966–77 |date=August 2008 |pmid=18508949 |doi=10.1177/0091270008319706 |url=}}</ref>
** The most common [[side effects]] of this drug are [[dizziness]], [[drowsiness]], [[nausea]], [[headache]], [[fatigue]], [[vertigo]], [[ataxia]], [[diplopia]], [[blurred vision]], and [[tremor]].<ref name="pmid25528898">{{cite journal |vauthors=Sperling MR, Abou-Khalil B, Harvey J, Rogin JB, Biraben A, Galimberti CA, Kowacs PA, Hong SB, Cheng H, Blum D, Nunes T, Soares-da-Silva P |title=Eslicarbazepine acetate as adjunctive therapy in patients with uncontrolled partial-onset seizures: Results of a phase III, double-blind, randomized, placebo-controlled trial |journal=Epilepsia |volume=56 |issue=2 |pages=244–53 |date=February 2015 |pmid=25528898 |pmc=4354260 |doi=10.1111/epi.12894 |url=}}</ref>
* [[Lacosamide]]
** It can be used for treatment of [[Focal seizures|focal-onset seizures]] in adult and children older than 4 y/o.<ref name="pmid19043448">{{cite journal |vauthors=Perucca E, Yasothan U, Clincke G, Kirkpatrick P |title=Lacosamide |journal=Nat Rev Drug Discov |volume=7 |issue=12 |pages=973–4 |date=December 2008 |pmid=19043448 |doi=10.1038/nrd2764 |url=}}</ref>
** The initial dosage is 50 mg twice/daily as adjunctive therapy in adults and 100 mg twice per day as monotherapy  .
** The maximum dosage is 200 to 400 mg per day. Children should be dosed according to body weight.<ref name="pmid17635557">{{cite journal |vauthors=Ben-Menachem E, Biton V, Jatuzis D, Abou-Khalil B, Doty P, Rudd GD, Halász P, Kälviäinen R, Mazurkiewicz-Beldzińska M, Rosenow F, Doty P, Hebert D, Sullivan T |title=Efficacy and safety of oral lacosamide as adjunctive therapy in adults with partial-onset seizures |journal=Epilepsia |volume=48 |issue=7 |pages=1308–17 |date=July 2007 |pmid=17635557 |doi=10.1111/j.1528-1167.2007.01188.x |url=}}</ref>
** The most common [[side effects]] are [[Dizziness]], [[nausea]], [[vertigo]], and [[ataxia]].<ref name="pmid190434482">{{cite journal |vauthors=Perucca E, Yasothan U, Clincke G, Kirkpatrick P |title=Lacosamide |journal=Nat Rev Drug Discov |volume=7 |issue=12 |pages=973–4 |date=December 2008 |pmid=19043448 |doi=10.1038/nrd2764 |url=}}</ref>
* [[Lamotrigine]]
** It can be used for adjunctive treatment for primary generalized [[Tonic-clonic seizure|tonic-clonic seizures]] and [[focal seizures]] in adults and children under two y/o.<ref name="pmid15111659">{{cite journal |vauthors=French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, Theodore WH, Bazil C, Stern J, Schachter SC, Bergen D, Hirtz D, Montouris GD, Nespeca M, Gidal B, Marks WJ, Turk WR, Fischer JH, Bourgeois B, Wilner A, Faught RE, Sachdeo RC, Beydoun A, Glauser TA |title=Efficacy and tolerability of the new antiepileptic drugs I: treatment of new onset epilepsy: report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society |journal=Neurology |volume=62 |issue=8 |pages=1252–60 |date=April 2004 |pmid=15111659 |doi= |url=}}</ref>
** The initial dosage is 25 mg/daily.
** The maximum dosage is 225 to 375 mg/daily<ref name="pmid15452293">{{cite journal |vauthors=Hirsch LJ, Weintraub D, Du Y, Buchsbaum R, Spencer HT, Hager M, Straka T, Bazil CW, Adams DJ, Resor SR, Morrell MJ |title=Correlating lamotrigine serum concentrations with tolerability in patients with epilepsy |journal=Neurology |volume=63 |issue=6 |pages=1022–6 |date=September 2004 |pmid=15452293 |doi= |url=}}</ref>
** The most common [[side effects]] are [[rash]] and [[nausea]].<ref name="pmid189813742">{{cite journal |vauthors=Hirsch LJ, Arif H, Nahm EA, Buchsbaum R, Resor SR, Bazil CW |title=Cross-sensitivity of skin rashes with antiepileptic drug use |journal=Neurology |volume=71 |issue=19 |pages=1527–34 |date=November 2008 |pmid=18981374 |doi=10.1212/01.wnl.0000334295.50403.4c |url=}}</ref>
* [[Oxcarbazepine]]
** It can be used for treatment of focal and secondarily generalized [[tonic-clonic seizures]].<ref name="pmid19821367">{{cite journal |vauthors=Koch MW, Polman SK |title=Oxcarbazepine versus carbamazepine monotherapy for partial onset seizures |journal=Cochrane Database Syst Rev |volume= |issue=4 |pages=CD006453 |date=October 2009 |pmid=19821367 |doi=10.1002/14651858.CD006453.pub2 |url=}}</ref>
** The initial dosage is 300 to 600 mg/day.
** The maximum dosage is 900 to 3000 mg/day.<ref name="pmid22091603">{{cite journal |vauthors=Kim DW, Gu N, Jang IJ, Chu K, Yu KS, Cho JY, Yoon SH, Kim HS, Oh J, Lee SK |title=Efficacy, tolerability, and pharmacokinetics of oxcarbazepine oral loading in patients with epilepsy |journal=Epilepsia |volume=53 |issue=1 |pages=e9–12 |date=January 2012 |pmid=22091603 |doi=10.1111/j.1528-1167.2011.03318.x |url=}}</ref>
** The most common [[side effects]] are [[hyponatremia]], [[sedation]], [[headache]], [[rash]], [[dizziness]], [[vertigo]], [[ataxia]], [[nausea]], and [[diplopia]].<ref name="pmid20132298">{{cite journal |vauthors=Buggy Y, Layton D, Fogg C, Shakir SA |title=Safety profile of oxcarbazepine: results from a prescription-event monitoring study |journal=Epilepsia |volume=51 |issue=5 |pages=818–29 |date=May 2010 |pmid=20132298 |doi=10.1111/j.1528-1167.2009.02489.x |url=}}</ref>
* [[Phenytoin]]
** It can be used for treatment of [[Focal Epilepsy|focal]]/[[Generalised epilepsy|generalized seizures]] and [[status epilepticus]].<ref name="pmid2428283">{{cite journal |vauthors=Yaari Y, Selzer ME, Pincus JH |title=Phenytoin: mechanisms of its anticonvulsant action |journal=Ann. Neurol. |volume=20 |issue=2 |pages=171–84 |date=August 1986 |pmid=2428283 |doi=10.1002/ana.410200202 |url=}}</ref>
** The initial dosage is 15 mg/kg/day in three doses.<ref name="pmid25099164">{{cite journal |vauthors=Caudle KE, Rettie AE, Whirl-Carrillo M, Smith LH, Mintzer S, Lee MT, Klein TE, Callaghan JT |title=Clinical pharmacogenetics implementation consortium guidelines for CYP2C9 and HLA-B genotypes and phenytoin dosing |journal=Clin. Pharmacol. Ther. |volume=96 |issue=5 |pages=542–8 |date=November 2014 |pmid=25099164 |doi=10.1038/clpt.2014.159 |url=}}</ref>
** The most common [[side effects]] are gingival hypertrophy, [[hirsutism]], [[rash]], [[Folic Acid|folic acid]] depletion, and decreased [[bone density]].<ref name="pmid6424397">{{cite journal |vauthors=Iivanainen M, Savolainen H |title=Side effects of phenobarbital and phenytoin during long-term treatment of epilepsy |journal=Acta Neurol. Scand., Suppl. |volume=97 |issue= |pages=49–67 |date=1983 |pmid=6424397 |doi= |url=}}</ref>
* [[Rufinamide]]
** It can be used for adjunctive treatment of seizures associated with [[Lennox-Gastaut syndrome|Lennox-gastaut syndrome]] (LGS).<ref name="pmid18401024">{{cite journal |vauthors=Glauser T, Kluger G, Sachdeo R, Krauss G, Perdomo C, Arroyo S |title=Rufinamide for generalized seizures associated with Lennox-Gastaut syndrome |journal=Neurology |volume=70 |issue=21 |pages=1950–8 |date=May 2008 |pmid=18401024 |doi=10.1212/01.wnl.0000303813.95800.0d |url=}}</ref>
** The initial dosage In children is 10 mg/kg per day in two divided doses and in adults is 400 to 800 mg per day in two divided doses.
** The maximum dosage in children is 45 mg/kg per day or 3200 mg/day and in adults is 3200 mg/day.<ref name="pmid20084538">{{cite journal |vauthors=Marchand M, Fuseau E, Critchley DJ |title=Supporting the recommended paediatric dosing regimen for rufinamide in Lennox-Gastaut syndrome using clinical trial simulation |journal=J Pharmacokinet Pharmacodyn |volume=37 |issue=1 |pages=99–118 |date=February 2010 |pmid=20084538 |doi=10.1007/s10928-009-9146-4 |url=}}</ref>
** The most common [[side effects]] are [[drowsiness]] and [[vomiting]].<ref name="pmid20126329">{{cite journal |vauthors=Wheless JW, Vazquez B |title=Rufinamide: a novel broad-spectrum antiepileptic drug |journal=Epilepsy Curr |volume=10 |issue=1 |pages=1–6 |date=January 2010 |pmid=20126329 |pmc=2812713 |doi=10.1111/j.1535-7511.2009.01336.x |url=}}</ref>
* Zonisamide
** It can be used for treatment of [[Focal Epilepsy|focal]] and [[Generalised epilepsy|generalized seizures]] in both adults and children.<ref name="pmid23837461">{{cite journal |vauthors=Guerrini R, Rosati A, Segieth J, Pellacani S, Bradshaw K, Giorgi L |title=A randomized phase III trial of adjunctive zonisamide in pediatric patients with partial epilepsy |journal=Epilepsia |volume=54 |issue=8 |pages=1473–80 |date=August 2013 |pmid=23837461 |doi=10.1111/epi.12233 |url=}}</ref>
** The initial dosage is 100 to 200 mg/daily in two divided doses.
** The maximum dosage is 400 to 600 mg/daily.<ref name="pmid15511691">{{cite journal |vauthors=Leppik IE |title=Zonisamide: chemistry, mechanism of action, and pharmacokinetics |journal=Seizure |volume=13 Suppl 1 |issue= |pages=S5–9; discussion S10 |date=December 2004 |pmid=15511691 |doi=10.1016/j.seizure.2004.04.016 |url=}}</ref>
** The most common [[side effects]] are [[drowsiness]], [[anxiety]], [[ataxia]], [[anorexia]], [[confusion]], abnormal thinking, [[fatigue]], [[dizziness]] and decreased sweating and [[fever]] in children. <ref name="pmid17945539">{{cite journal |vauthors=Park SP, Hwang YH, Lee HW, Suh CK, Kwon SH, Lee BI |title=Long-term cognitive and mood effects of zonisamide monotherapy in epilepsy patients |journal=Epilepsy Behav |volume=12 |issue=1 |pages=102–8 |date=January 2008 |pmid=17945539 |doi=10.1016/j.yebeh.2007.08.002 |url=}}</ref>
=== Drugs that affect Ca currents ===
* [[Ethosuximide]]
** It can be used for treatment of [[Absence seizure|absence seizures]].
** The initial dosage is 20 to 40 mg/kg/day.
** The maximum serum level is 40 to 100 mcg/mL (280 to 700 micromol/L).
** The most common [[side effects]] are [[nausea]] and [[vomiting]], sleep disorders and [[somnolence]].<ref name="pmid20200383">{{cite journal |vauthors=Glauser TA, Cnaan A, Shinnar S, Hirtz DG, Dlugos D, Masur D, Clark PO, Capparelli EV, Adamson PC |title=Ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy |journal=N. Engl. J. Med. |volume=362 |issue=9 |pages=790–9 |date=March 2010 |pmid=20200383 |pmc=2924476 |doi=10.1056/NEJMoa0902014 |url=}}</ref>
=== Drugs that affect [[GABA]] activity ===
* [[Benzodiazepine|Benzodiazepines]]
** It can be used for adjunctive therapy for [[Myoclonic seizure|myoclonic]]/[[Atonic seizure|atonic seizures]] and [[Focal Epilepsy|focal]]/[[Generalised epilepsy|generalized tonic-clonic seizures]].
** The most common [[side effects]] are [[anterograde amnesia]], [[drowsiness]] and increased risk of falling in elderly persons.<ref name="pmid20305598">{{cite journal |vauthors=Uzun S, Kozumplik O, Jakovljević M, Sedić B |title=Side effects of treatment with benzodiazepines |journal=Psychiatr Danub |volume=22 |issue=1 |pages=90–3 |date=March 2010 |pmid=20305598 |doi= |url=}}</ref>
* [[Phenobarbital]]
** It can be used for treatment of generalized and [[focal seizures]].
** The initial dosage is 1 to 5 mg/kg per day.
** The goal therapeutic level is 10 to 40 mcg/mL (43 to 172 micromol/L).<ref name="urlapps.who.int">{{cite web |url=http://apps.who.int/iris/bitstream/handle/10665/61822/WHO_MNH_MND_90.3.pdf?sequence=1&isAllowed=y |title=apps.who.int |format= |work= |accessdate=}}</ref>
** The most common [[side effects]] are sleep disturbance and daytime irritability.<ref name="pmid381616">{{cite journal |vauthors=Camfield CS, Chaplin S, Doyle AB, Shapiro SH, Cummings C, Camfield PR |title=Side effects of phenobarbital in toddlers; behavioral and cognitive aspects |journal=J. Pediatr. |volume=95 |issue=3 |pages=361–5 |date=September 1979 |pmid=381616 |doi= |url=}}</ref>
* [[Tiagabine]]
** It can be used for adjunctive treatment for [[focal seizures]].<ref name="pmid151116592">{{cite journal |vauthors=French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, Theodore WH, Bazil C, Stern J, Schachter SC, Bergen D, Hirtz D, Montouris GD, Nespeca M, Gidal B, Marks WJ, Turk WR, Fischer JH, Bourgeois B, Wilner A, Faught RE, Sachdeo RC, Beydoun A, Glauser TA |title=Efficacy and tolerability of the new antiepileptic drugs I: treatment of new onset epilepsy: report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society |journal=Neurology |volume=62 |issue=8 |pages=1252–60 |date=April 2004 |pmid=15111659 |doi= |url=}}</ref>
** The initial dosage is 4 to 8 mg/day.
** The most common [[side effects]] are [[dizziness]], [[somnolence]], [[anxiety]], [[tremor]], difficulty concentrating, [[nausea]] and abdominal pain.<ref name="pmid22592677">{{cite journal |vauthors=Pulman J, Marson AG, Hutton JL, French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, Theodore WH, Bazil C, Stern J, Schachter SC, Bergen D, Hirtz D, Montouris GD, Nespeca M, Gidal B, Marks WJ, Turk WR, Fischer JH, Bourgeois B, Wilner A, Faught RE, Sachdeo RC, Beydoun A, Glauser TA |title=Tiagabine add-on for drug-resistant partial epilepsy |journal=Cochrane Database Syst Rev |volume=62 |issue=5 |pages=CD001908 |date=May 2012 |pmid=22592677 |pmc=4058679 |doi=10.1002/14651858.CD001908.pub2 |url=}}</ref>
* [[Vigabatrin]]
** It can be used for add-on treatment for refractory [[focal seizures]].<ref name="pmid23440814">{{cite journal |vauthors=Hemming K, Maguire MJ, Hutton JL, Marson AG |title=Vigabatrin for refractory partial epilepsy |journal=Cochrane Database Syst Rev |volume= |issue=1 |pages=CD007302 |date=January 2013 |pmid=23440814 |doi=10.1002/14651858.CD007302.pub2 |url=}}</ref>
** The initial dosage is 500 mg/day.
** The maximum dosage is 3 gr/day.<ref name="pmid20208475">{{cite journal |vauthors= |title=Vigabatrin (Sabril) for epilepsy |journal=Med Lett Drugs Ther |volume=52 |issue=1332 |pages=14–6; quiz 17 |date=February 2010 |pmid=20208475 |doi= |url=}}</ref>
** The most common [[side effects]] are  [[visual loss]], [[drowsiness]], [[fatigue]], [[headache]], and [[dizziness]].<ref name="pmid10406359">{{cite journal |vauthors=Chadwick D |title=Safety and efficacy of vigabatrin and carbamazepine in newly diagnosed epilepsy: a multicentre randomised double-blind study. Vigabatrin European Monotherapy Study Group |journal=Lancet |volume=354 |issue=9172 |pages=13–9 |date=July 1999 |pmid=10406359 |doi= |url=}}</ref>
=== Drugs that affect glutamate receptor ===
* [[Perampanel]]
** It can be used for treatment of [[Focal Epilepsy|focal-onset seizures]]  in patients older than 12 y/o and as adjunctive treatment for primary [[Tonic-clonic seizures|generalized tonic-clonic seizures]].<ref name="urlDrugs@FDA: FDA Approved Drug Products">{{cite web |url=http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm |title=Drugs@FDA: FDA Approved Drug Products |format= |work= |accessdate=}}</ref>
** The initial dosage is 2 mg/day.
** The maximum dose is 12 mg/day.<ref name="pmid25461214">{{cite journal |vauthors=Coyle H, Clough P, Cooper P, Mohanraj R |title=Clinical experience with perampanel: focus on psychiatric adverse effects |journal=Epilepsy Behav |volume=41 |issue= |pages=193–6 |date=December 2014 |pmid=25461214 |doi=10.1016/j.yebeh.2014.09.072 |url=}}</ref>
** The most common [[side effects]] are [[dizziness]], [[drowsiness]], [[headache]], [[fatigue]], [[irritability]], [[ataxia]], [[nausea]], and weight gain.<ref name="pmid22843280">{{cite journal |vauthors=French JA, Krauss GL, Biton V, Squillacote D, Yang H, Laurenza A, Kumar D, Rogawski MA |title=Adjunctive perampanel for refractory partial-onset seizures: randomized phase III study 304 |journal=Neurology |volume=79 |issue=6 |pages=589–96 |date=August 2012 |pmid=22843280 |pmc=3413761 |doi=10.1212/WNL.0b013e3182635735 |url=}}</ref>
=== Drugs with multiple mechanisms of action ===
* [[Felbamate]]
** It can be used for treatment of [[focal seizures]] and [[Lennox-Gastaut syndrome]] (LGS).<ref name="pmid8039474">{{cite journal |vauthors=Bourgeois BF |title=Felbamate in the treatment of partial-onset seizures |journal=Epilepsia |volume=35 Suppl 5 |issue= |pages=S58–61 |date=1994 |pmid=8039474 |doi= |url=}}</ref>
** This drug can cause fatal [[aplastic anemia]] and [[hepatic failure]].<ref name="pmid8628501">{{cite journal |vauthors=O'Neil MG, Perdun CS, Wilson MB, McGown ST, Patel S |title=Felbamate-associated fatal acute hepatic necrosis |journal=Neurology |volume=46 |issue=5 |pages=1457–9 |date=May 1996 |pmid=8628501 |doi= |url=}}</ref>
* [[Topiramate]]
** It can be used for treatment of [[focal seizures]] in adults and children older than two y/o.<ref name="pmid24570033">{{cite journal |vauthors=Pulman J, Jette N, Dykeman J, Hemming K, Hutton JL, Marson AG |title=Topiramate add-on for drug-resistant partial epilepsy |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD001417 |date=February 2014 |pmid=24570033 |doi=10.1002/14651858.CD001417.pub3 |url=}}</ref>
** The initial dosage is 50 mg/day.<ref name="pmid20633037">{{cite journal |vauthors=Ramsay E, Faught E, Krumholz A, Naritoku D, Privitera M, Schwarzman L, Mao L, Wiegand F, Hulihan J |title=Efficacy, tolerability, and safety of rapid initiation of topiramate versus phenytoin in patients with new-onset epilepsy: a randomized double-blind clinical trial |journal=Epilepsia |volume=51 |issue=10 |pages=1970–7 |date=October 2010 |pmid=20633037 |doi=10.1111/j.1528-1167.2010.02670.x |url=}}</ref>
** The most common [[side effects]] are Weight loss, [[Paresthesia|paresthesias]], [[drowsiness]], [[dizziness]], [[depression]], [[headache]], [[cognition]] and language impairment.<ref name="pmid15857429">{{cite journal |vauthors=Majkowski J, Neto W, Wapenaar R, Van Oene J |title=Time course of adverse events in patients with localization-related epilepsy receiving topiramate added to carbamazepine |journal=Epilepsia |volume=46 |issue=5 |pages=648–53 |date=May 2005 |pmid=15857429 |doi=10.1111/j.1528-1167.2005.35904.x |url=}}</ref>
* Valporate
** It can be used for treatment of [[Generalised epilepsy|generalized]] and [[focal seizures]].
** The initial dosage is 10 to 15 mg/kg per day.<ref name="pmid6425050">{{cite journal |vauthors=Loiseau P |title=Rational use of valproate: indications and drug regimen in epilepsy |journal=Epilepsia |volume=25 Suppl 1 |issue= |pages=S65–72 |date=1984 |pmid=6425050 |doi= |url=}}</ref>
** The most common [[side effects]] are [[nausea]], [[vomiting]], hair loss, [[easy bruising]], [[tremor]], weight gain, [[obesity]], [[insulin resistance]], [[metabolic syndrome]], [[thrombocytopenia]] and other [[coagulation]] disturbances, subclinical [[hypothyroidism]], [[Polycystic ovary syndrome|polycystic ovarian syndrome]], [[fanconi syndrome]].<ref name="pmid11160951">{{cite journal |vauthors=Biton V, Mirza W, Montouris G, Vuong A, Hammer AE, Barrett PS |title=Weight change associated with valproate and lamotrigine monotherapy in patients with epilepsy |journal=Neurology |volume=56 |issue=2 |pages=172–7 |date=January 2001 |pmid=11160951 |doi= |url=}}</ref><ref name="pmid20304335">{{cite journal |vauthors=Endo A, Fujita Y, Fuchigami T, Takahashi S, Mugishima H |title=Fanconi syndrome caused by valproic acid |journal=Pediatr. Neurol. |volume=42 |issue=4 |pages=287–90 |date=April 2010 |pmid=20304335 |doi=10.1016/j.pediatrneurol.2009.12.003 |url=}}</ref><ref name="pmid16886976">{{cite journal |vauthors=Gerstner T, Teich M, Bell N, Longin E, Dempfle CE, Brand J, König S |title=Valproate-associated coagulopathies are frequent and variable in children |journal=Epilepsia |volume=47 |issue=7 |pages=1136–43 |date=July 2006 |pmid=16886976 |doi=10.1111/j.1528-1167.2006.00587.x |url=}}</ref><ref name="pmid18503558">{{cite journal |vauthors=Sahota P, Prabhakar S, Kharbanda PS, Bhansali A, Jain V, Das CP, Modi M |title=Seizure type, antiepileptic drugs, and reproductive endocrine dysfunction in Indian women with epilepsy: a cross-sectional study |journal=Epilepsia |volume=49 |issue=12 |pages=2069–77 |date=December 2008 |pmid=18503558 |doi=10.1111/j.1528-1167.2008.01676.x |url=}}</ref><ref name="pmid21824562">{{cite journal |vauthors=Aggarwal A, Rastogi N, Mittal H, Chillar N, Patil R |title=Thyroid hormone levels in children receiving carbamazepine or valproate |journal=Pediatr. Neurol. |volume=45 |issue=3 |pages=159–62 |date=September 2011 |pmid=21824562 |doi=10.1016/j.pediatrneurol.2011.04.005 |url=}}</ref>
=== Drugs with other mechanisms of action ===
* Brivaracetam
** It can be used for treatment of focal-onset seizures and generalized epilepsy.<ref name="pmid26471380">{{cite journal |vauthors=Klein P, Schiemann J, Sperling MR, Whitesides J, Liang W, Stalvey T, Brandt C, Kwan P |title=A randomized, double-blind, placebo-controlled, multicenter, parallel-group study to evaluate the efficacy and safety of adjunctive brivaracetam in adult patients with uncontrolled partial-onset seizures |journal=Epilepsia |volume=56 |issue=12 |pages=1890–8 |date=December 2015 |pmid=26471380 |doi=10.1111/epi.13212 |url=}}</ref><ref name="pmid264713803">{{cite journal |vauthors=Klein P, Schiemann J, Sperling MR, Whitesides J, Liang W, Stalvey T, Brandt C, Kwan P |title=A randomized, double-blind, placebo-controlled, multicenter, parallel-group study to evaluate the efficacy and safety of adjunctive brivaracetam in adult patients with uncontrolled partial-onset seizures |journal=Epilepsia |volume=56 |issue=12 |pages=1890–8 |date=December 2015 |pmid=26471380 |doi=10.1111/epi.13212 |url=}}</ref>
** The initial dosage is 50 mg twice daily.<ref name="urlDrugs@FDA: FDA Approved Drug Products2">{{cite web |url=http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Overview&DrugName=BRIVIACT |title=Drugs@FDA: FDA Approved Drug Products |format= |work= |accessdate=}}</ref>
** The most common side effects are irritability, anxiety, insomnia and depression.<ref name="pmid264713802">{{cite journal |vauthors=Klein P, Schiemann J, Sperling MR, Whitesides J, Liang W, Stalvey T, Brandt C, Kwan P |title=A randomized, double-blind, placebo-controlled, multicenter, parallel-group study to evaluate the efficacy and safety of adjunctive brivaracetam in adult patients with uncontrolled partial-onset seizures |journal=Epilepsia |volume=56 |issue=12 |pages=1890–8 |date=December 2015 |pmid=26471380 |doi=10.1111/epi.13212 |url=}}</ref>
* Gabapentin
** It can be used for treatment of refractory focal seizures.<ref name="pmid15111660">{{cite journal |vauthors=French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, Theodore WH, Bazil C, Stern J, Schachter SC, Bergen D, Hirtz D, Montouris GD, Nespeca M, Gidal B, Marks WJ, Turk WR, Fischer JH, Bourgeois B, Wilner A, Faught RE, Sachdeo RC, Beydoun A, Glauser TA |title=Efficacy and tolerability of the new antiepileptic drugs II: treatment of refractory epilepsy: report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society |journal=Neurology |volume=62 |issue=8 |pages=1261–73 |date=April 2004 |pmid=15111660 |doi= |url=}}</ref>
** The initial dosage is 300 mg three times daily.
** The maximum dosage is 2400 mg/day.<ref name="pmid23888424">{{cite journal |vauthors=Al-Bachari S, Pulman J, Hutton JL, Marson AG |title=Gabapentin add-on for drug-resistant partial epilepsy |journal=Cochrane Database Syst Rev |volume= |issue=7 |pages=CD001415 |date=July 2013 |pmid=23888424 |doi=10.1002/14651858.CD001415.pub2 |url=}}</ref>
** The most common side effects are sedation, dizziness, ataxia and weight gain.<ref name="pmid27265421">{{cite journal |vauthors=Smith RV, Havens JR, Walsh SL |title=Gabapentin misuse, abuse and diversion: a systematic review |journal=Addiction |volume=111 |issue=7 |pages=1160–74 |date=July 2016 |pmid=27265421 |pmc=5573873 |doi=10.1111/add.13324 |url=}}</ref>
* Levetiracetam
** It can be used for adjunctive  treatment of focal-onset seizures, myoclonic seizures in patients older than 12 y/o with juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures in patients older than six y/o with idiopathic generalized epilepsy.<ref name="pmid17625106">{{cite journal |vauthors=Berkovic SF, Knowlton RC, Leroy RF, Schiemann J, Falter U |title=Placebo-controlled study of levetiracetam in idiopathic generalized epilepsy |journal=Neurology |volume=69 |issue=18 |pages=1751–60 |date=October 2007 |pmid=17625106 |doi=10.1212/01.wnl.0000268699.34614.d3 |url=}}</ref><ref name="pmid22972056">{{cite journal |vauthors=Mbizvo GK, Dixon P, Hutton JL, Marson AG |title=Levetiracetam add-on for drug-resistant focal epilepsy: an updated Cochrane Review |journal=Cochrane Database Syst Rev |volume= |issue=9 |pages=CD001901 |date=September 2012 |pmid=22972056 |doi=10.1002/14651858.CD001901.pub2 |url=}}</ref><ref name="pmid22050371">{{cite journal |vauthors=Delanty N, Jones J, Tonner F |title=Adjunctive levetiracetam in children, adolescents, and adults with primary generalized seizures: open-label, noncomparative, multicenter, long-term follow-up study |journal=Epilepsia |volume=53 |issue=1 |pages=111–9 |date=January 2012 |pmid=22050371 |doi=10.1111/j.1528-1167.2011.03300.x |url=}}</ref>
** The initial dosage is 500 mg twice daily.
** The maximum dosage is 4000 mg daily.<ref name="pmid10845730">{{cite journal |vauthors=Betts T, Waegemans T, Crawford P |title=A multicentre, double-blind, randomized, parallel group study to evaluate the tolerability and efficacy of two oral doses of levetiracetam, 2000 mg daily and 4000 mg daily, without titration in patients with refractory epilepsy |journal=Seizure |volume=9 |issue=2 |pages=80–7 |date=March 2000 |pmid=10845730 |doi=10.1053/seiz.2000.0380 |url=}}</ref>
** The most common side effects are fatigue, drowsiness, dizziness, and upper respiratory tract infection.<ref name="pmid220503712">{{cite journal |vauthors=Delanty N, Jones J, Tonner F |title=Adjunctive levetiracetam in children, adolescents, and adults with primary generalized seizures: open-label, noncomparative, multicenter, long-term follow-up study |journal=Epilepsia |volume=53 |issue=1 |pages=111–9 |date=January 2012 |pmid=22050371 |doi=10.1111/j.1528-1167.2011.03300.x |url=}}</ref>
* Pregabalin
** It can be used for adjunctive therapy for focal seizures.<ref name="pmid14692903">{{cite journal |vauthors=Arroyo S, Anhut H, Kugler AR, Lee CM, Knapp LE, Garofalo EA, Messmer S |title=Pregabalin add-on treatment: a randomized, double-blind, placebo-controlled, dose-response study in adults with partial seizures |journal=Epilepsia |volume=45 |issue=1 |pages=20–7 |date=January 2004 |pmid=14692903 |doi= |url=}}</ref>
** The initial dosage is 150 mg daily in either two or three divided doses.<ref name="pmid15740180">{{cite journal |vauthors=Warner G, Figgitt DP |title=Pregabalin: as adjunctive treatment of partial seizures |journal=CNS Drugs |volume=19 |issue=3 |pages=265–72; discussion 273–4 |date=2005 |pmid=15740180 |doi=10.2165/00023210-200519030-00007 |url=}}</ref>
** The most common side effects are dizziness, gait abnormalities and drowsiness.<ref name="pmid21320112">{{cite journal |vauthors=Zaccara G, Gangemi P, Perucca P, Specchio L |title=The adverse event profile of pregabalin: a systematic review and meta-analysis of randomized controlled trials |journal=Epilepsia |volume=52 |issue=4 |pages=826–36 |date=April 2011 |pmid=21320112 |doi=10.1111/j.1528-1167.2010.02966.x |url=}}</ref>
==References==
==References==
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Latest revision as of 21:37, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

overview

Medical Therapy

Pharmacologic medical therapies for epilepsy is anti-seizure drugs such as:

Drugs that affect voltage-dependent Na+ channels

Drugs that affect Ca currents

Drugs that affect GABA activity

Drugs that affect glutamate receptor

Drugs with multiple mechanisms of action

Drugs with other mechanisms of action

  • Brivaracetam
    • It can be used for treatment of focal-onset seizures and generalized epilepsy.[47][48]
    • The initial dosage is 50 mg twice daily.[49]
    • The most common side effects are irritability, anxiety, insomnia and depression.[50]
  • Gabapentin
    • It can be used for treatment of refractory focal seizures.[51]
    • The initial dosage is 300 mg three times daily.
    • The maximum dosage is 2400 mg/day.[52]
    • The most common side effects are sedation, dizziness, ataxia and weight gain.[53]
  • Levetiracetam
    • It can be used for adjunctive treatment of focal-onset seizures, myoclonic seizures in patients older than 12 y/o with juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures in patients older than six y/o with idiopathic generalized epilepsy.[54][55][56]
    • The initial dosage is 500 mg twice daily.
    • The maximum dosage is 4000 mg daily.[57]
    • The most common side effects are fatigue, drowsiness, dizziness, and upper respiratory tract infection.[58]
  • Pregabalin
    • It can be used for adjunctive therapy for focal seizures.[59]
    • The initial dosage is 150 mg daily in either two or three divided doses.[60]
    • The most common side effects are dizziness, gait abnormalities and drowsiness.[61]

References

  1. ↑ Hirsch LJ, Arif H, Nahm EA, Buchsbaum R, Resor SR, Bazil CW (November 2008). "Cross-sensitivity of skin rashes with antiepileptic drug use". Neurology. 71 (19): 1527–34. doi:10.1212/01.wnl.0000334295.50403.4c. PMID 18981374.
  2. ↑ Cereghino JJ, Brock JT, Van Meter JC, Penry JK, Smith LD, White BG (May 1974). "Carbamazepine for epilepsy. A controlled prospective evaluation". Neurology. 24 (5): 401–10. PMID 4207990.
  3. ↑ Chang XC, Yuan H, Wang Y, Xu HQ, Hong WK, Zheng RY (October 2017). "Eslicarbazepine acetate add-on for drug-resistant partial epilepsy". Cochrane Database Syst Rev. 10: CD008907. doi:10.1002/14651858.CD008907.pub3. PMID 29067682.
  4. ↑ Almeida L, Minciu I, Nunes T, Butoianu N, Falcão A, Magureanu SA, Soares-da-Silva P (August 2008). "Pharmacokinetics, efficacy, and tolerability of eslicarbazepine acetate in children and adolescents with epilepsy". J Clin Pharmacol. 48 (8): 966–77. doi:10.1177/0091270008319706. PMID 18508949.
  5. ↑ Sperling MR, Abou-Khalil B, Harvey J, Rogin JB, Biraben A, Galimberti CA, Kowacs PA, Hong SB, Cheng H, Blum D, Nunes T, Soares-da-Silva P (February 2015). "Eslicarbazepine acetate as adjunctive therapy in patients with uncontrolled partial-onset seizures: Results of a phase III, double-blind, randomized, placebo-controlled trial". Epilepsia. 56 (2): 244–53. doi:10.1111/epi.12894. PMC 4354260. PMID 25528898.
  6. ↑ Perucca E, Yasothan U, Clincke G, Kirkpatrick P (December 2008). "Lacosamide". Nat Rev Drug Discov. 7 (12): 973–4. doi:10.1038/nrd2764. PMID 19043448.
  7. ↑ Ben-Menachem E, Biton V, Jatuzis D, Abou-Khalil B, Doty P, Rudd GD, Halász P, Kälviäinen R, Mazurkiewicz-Beldzińska M, Rosenow F, Doty P, Hebert D, Sullivan T (July 2007). "Efficacy and safety of oral lacosamide as adjunctive therapy in adults with partial-onset seizures". Epilepsia. 48 (7): 1308–17. doi:10.1111/j.1528-1167.2007.01188.x. PMID 17635557.
  8. ↑ Perucca E, Yasothan U, Clincke G, Kirkpatrick P (December 2008). "Lacosamide". Nat Rev Drug Discov. 7 (12): 973–4. doi:10.1038/nrd2764. PMID 19043448.
  9. ↑ French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, Theodore WH, Bazil C, Stern J, Schachter SC, Bergen D, Hirtz D, Montouris GD, Nespeca M, Gidal B, Marks WJ, Turk WR, Fischer JH, Bourgeois B, Wilner A, Faught RE, Sachdeo RC, Beydoun A, Glauser TA (April 2004). "Efficacy and tolerability of the new antiepileptic drugs I: treatment of new onset epilepsy: report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society". Neurology. 62 (8): 1252–60. PMID 15111659.
  10. ↑ Hirsch LJ, Weintraub D, Du Y, Buchsbaum R, Spencer HT, Hager M, Straka T, Bazil CW, Adams DJ, Resor SR, Morrell MJ (September 2004). "Correlating lamotrigine serum concentrations with tolerability in patients with epilepsy". Neurology. 63 (6): 1022–6. PMID 15452293.
  11. ↑ Hirsch LJ, Arif H, Nahm EA, Buchsbaum R, Resor SR, Bazil CW (November 2008). "Cross-sensitivity of skin rashes with antiepileptic drug use". Neurology. 71 (19): 1527–34. doi:10.1212/01.wnl.0000334295.50403.4c. PMID 18981374.
  12. ↑ Koch MW, Polman SK (October 2009). "Oxcarbazepine versus carbamazepine monotherapy for partial onset seizures". Cochrane Database Syst Rev (4): CD006453. doi:10.1002/14651858.CD006453.pub2. PMID 19821367.
  13. ↑ Kim DW, Gu N, Jang IJ, Chu K, Yu KS, Cho JY, Yoon SH, Kim HS, Oh J, Lee SK (January 2012). "Efficacy, tolerability, and pharmacokinetics of oxcarbazepine oral loading in patients with epilepsy". Epilepsia. 53 (1): e9–12. doi:10.1111/j.1528-1167.2011.03318.x. PMID 22091603.
  14. ↑ Buggy Y, Layton D, Fogg C, Shakir SA (May 2010). "Safety profile of oxcarbazepine: results from a prescription-event monitoring study". Epilepsia. 51 (5): 818–29. doi:10.1111/j.1528-1167.2009.02489.x. PMID 20132298.
  15. ↑ Yaari Y, Selzer ME, Pincus JH (August 1986). "Phenytoin: mechanisms of its anticonvulsant action". Ann. Neurol. 20 (2): 171–84. doi:10.1002/ana.410200202. PMID 2428283.
  16. ↑ Caudle KE, Rettie AE, Whirl-Carrillo M, Smith LH, Mintzer S, Lee MT, Klein TE, Callaghan JT (November 2014). "Clinical pharmacogenetics implementation consortium guidelines for CYP2C9 and HLA-B genotypes and phenytoin dosing". Clin. Pharmacol. Ther. 96 (5): 542–8. doi:10.1038/clpt.2014.159. PMID 25099164.
  17. ↑ Iivanainen M, Savolainen H (1983). "Side effects of phenobarbital and phenytoin during long-term treatment of epilepsy". Acta Neurol. Scand., Suppl. 97: 49–67. PMID 6424397.
  18. ↑ Glauser T, Kluger G, Sachdeo R, Krauss G, Perdomo C, Arroyo S (May 2008). "Rufinamide for generalized seizures associated with Lennox-Gastaut syndrome". Neurology. 70 (21): 1950–8. doi:10.1212/01.wnl.0000303813.95800.0d. PMID 18401024.
  19. ↑ Marchand M, Fuseau E, Critchley DJ (February 2010). "Supporting the recommended paediatric dosing regimen for rufinamide in Lennox-Gastaut syndrome using clinical trial simulation". J Pharmacokinet Pharmacodyn. 37 (1): 99–118. doi:10.1007/s10928-009-9146-4. PMID 20084538.
  20. ↑ Wheless JW, Vazquez B (January 2010). "Rufinamide: a novel broad-spectrum antiepileptic drug". Epilepsy Curr. 10 (1): 1–6. doi:10.1111/j.1535-7511.2009.01336.x. PMC 2812713. PMID 20126329.
  21. ↑ Guerrini R, Rosati A, Segieth J, Pellacani S, Bradshaw K, Giorgi L (August 2013). "A randomized phase III trial of adjunctive zonisamide in pediatric patients with partial epilepsy". Epilepsia. 54 (8): 1473–80. doi:10.1111/epi.12233. PMID 23837461.
  22. ↑ Leppik IE (December 2004). "Zonisamide: chemistry, mechanism of action, and pharmacokinetics". Seizure. 13 Suppl 1: S5–9, discussion S10. doi:10.1016/j.seizure.2004.04.016. PMID 15511691.
  23. ↑ Park SP, Hwang YH, Lee HW, Suh CK, Kwon SH, Lee BI (January 2008). "Long-term cognitive and mood effects of zonisamide monotherapy in epilepsy patients". Epilepsy Behav. 12 (1): 102–8. doi:10.1016/j.yebeh.2007.08.002. PMID 17945539.
  24. ↑ Glauser TA, Cnaan A, Shinnar S, Hirtz DG, Dlugos D, Masur D, Clark PO, Capparelli EV, Adamson PC (March 2010). "Ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy". N. Engl. J. Med. 362 (9): 790–9. doi:10.1056/NEJMoa0902014. PMC 2924476. PMID 20200383.
  25. ↑ Uzun S, Kozumplik O, Jakovljević M, Sedić B (March 2010). "Side effects of treatment with benzodiazepines". Psychiatr Danub. 22 (1): 90–3. PMID 20305598.
  26. ↑ "apps.who.int" (PDF).
  27. ↑ Camfield CS, Chaplin S, Doyle AB, Shapiro SH, Cummings C, Camfield PR (September 1979). "Side effects of phenobarbital in toddlers; behavioral and cognitive aspects". J. Pediatr. 95 (3): 361–5. PMID 381616.
  28. ↑ French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, Theodore WH, Bazil C, Stern J, Schachter SC, Bergen D, Hirtz D, Montouris GD, Nespeca M, Gidal B, Marks WJ, Turk WR, Fischer JH, Bourgeois B, Wilner A, Faught RE, Sachdeo RC, Beydoun A, Glauser TA (April 2004). "Efficacy and tolerability of the new antiepileptic drugs I: treatment of new onset epilepsy: report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society". Neurology. 62 (8): 1252–60. PMID 15111659.
  29. ↑ Pulman J, Marson AG, Hutton JL, French JA, Kanner AM, Bautista J, Abou-Khalil B, Browne T, Harden CL, Theodore WH, Bazil C, Stern J, Schachter SC, Bergen D, Hirtz D, Montouris GD, Nespeca M, Gidal B, Marks WJ, Turk WR, Fischer JH, Bourgeois B, Wilner A, Faught RE, Sachdeo RC, Beydoun A, Glauser TA (May 2012). "Tiagabine add-on for drug-resistant partial epilepsy". Cochrane Database Syst Rev. 62 (5): CD001908. doi:10.1002/14651858.CD001908.pub2. PMC 4058679. PMID 22592677.
  30. ↑ Hemming K, Maguire MJ, Hutton JL, Marson AG (January 2013). "Vigabatrin for refractory partial epilepsy". Cochrane Database Syst Rev (1): CD007302. doi:10.1002/14651858.CD007302.pub2. PMID 23440814.
  31. ↑ "Vigabatrin (Sabril) for epilepsy". Med Lett Drugs Ther. 52 (1332): 14–6, quiz 17. February 2010. PMID 20208475.
  32. ↑ Chadwick D (July 1999). "Safety and efficacy of vigabatrin and carbamazepine in newly diagnosed epilepsy: a multicentre randomised double-blind study. Vigabatrin European Monotherapy Study Group". Lancet. 354 (9172): 13–9. PMID 10406359.
  33. ↑ "Drugs@FDA: FDA Approved Drug Products".
  34. ↑ Coyle H, Clough P, Cooper P, Mohanraj R (December 2014). "Clinical experience with perampanel: focus on psychiatric adverse effects". Epilepsy Behav. 41: 193–6. doi:10.1016/j.yebeh.2014.09.072. PMID 25461214.
  35. ↑ French JA, Krauss GL, Biton V, Squillacote D, Yang H, Laurenza A, Kumar D, Rogawski MA (August 2012). "Adjunctive perampanel for refractory partial-onset seizures: randomized phase III study 304". Neurology. 79 (6): 589–96. doi:10.1212/WNL.0b013e3182635735. PMC 3413761. PMID 22843280.
  36. ↑ Bourgeois BF (1994). "Felbamate in the treatment of partial-onset seizures". Epilepsia. 35 Suppl 5: S58–61. PMID 8039474.
  37. ↑ O'Neil MG, Perdun CS, Wilson MB, McGown ST, Patel S (May 1996). "Felbamate-associated fatal acute hepatic necrosis". Neurology. 46 (5): 1457–9. PMID 8628501.
  38. ↑ Pulman J, Jette N, Dykeman J, Hemming K, Hutton JL, Marson AG (February 2014). "Topiramate add-on for drug-resistant partial epilepsy". Cochrane Database Syst Rev (2): CD001417. doi:10.1002/14651858.CD001417.pub3. PMID 24570033.
  39. ↑ Ramsay E, Faught E, Krumholz A, Naritoku D, Privitera M, Schwarzman L, Mao L, Wiegand F, Hulihan J (October 2010). "Efficacy, tolerability, and safety of rapid initiation of topiramate versus phenytoin in patients with new-onset epilepsy: a randomized double-blind clinical trial". Epilepsia. 51 (10): 1970–7. doi:10.1111/j.1528-1167.2010.02670.x. PMID 20633037.
  40. ↑ Majkowski J, Neto W, Wapenaar R, Van Oene J (May 2005). "Time course of adverse events in patients with localization-related epilepsy receiving topiramate added to carbamazepine". Epilepsia. 46 (5): 648–53. doi:10.1111/j.1528-1167.2005.35904.x. PMID 15857429.
  41. ↑ Loiseau P (1984). "Rational use of valproate: indications and drug regimen in epilepsy". Epilepsia. 25 Suppl 1: S65–72. PMID 6425050.
  42. ↑ Biton V, Mirza W, Montouris G, Vuong A, Hammer AE, Barrett PS (January 2001). "Weight change associated with valproate and lamotrigine monotherapy in patients with epilepsy". Neurology. 56 (2): 172–7. PMID 11160951.
  43. ↑ Endo A, Fujita Y, Fuchigami T, Takahashi S, Mugishima H (April 2010). "Fanconi syndrome caused by valproic acid". Pediatr. Neurol. 42 (4): 287–90. doi:10.1016/j.pediatrneurol.2009.12.003. PMID 20304335.
  44. ↑ Gerstner T, Teich M, Bell N, Longin E, Dempfle CE, Brand J, König S (July 2006). "Valproate-associated coagulopathies are frequent and variable in children". Epilepsia. 47 (7): 1136–43. doi:10.1111/j.1528-1167.2006.00587.x. PMID 16886976.
  45. ↑ Sahota P, Prabhakar S, Kharbanda PS, Bhansali A, Jain V, Das CP, Modi M (December 2008). "Seizure type, antiepileptic drugs, and reproductive endocrine dysfunction in Indian women with epilepsy: a cross-sectional study". Epilepsia. 49 (12): 2069–77. doi:10.1111/j.1528-1167.2008.01676.x. PMID 18503558.
  46. ↑ Aggarwal A, Rastogi N, Mittal H, Chillar N, Patil R (September 2011). "Thyroid hormone levels in children receiving carbamazepine or valproate". Pediatr. Neurol. 45 (3): 159–62. doi:10.1016/j.pediatrneurol.2011.04.005. PMID 21824562.
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  59. ↑ Arroyo S, Anhut H, Kugler AR, Lee CM, Knapp LE, Garofalo EA, Messmer S (January 2004). "Pregabalin add-on treatment: a randomized, double-blind, placebo-controlled, dose-response study in adults with partial seizures". Epilepsia. 45 (1): 20–7. PMID 14692903.
  60. ↑ Warner G, Figgitt DP (2005). "Pregabalin: as adjunctive treatment of partial seizures". CNS Drugs. 19 (3): 265–72, discussion 273–4. doi:10.2165/00023210-200519030-00007. PMID 15740180.
  61. ↑ Zaccara G, Gangemi P, Perucca P, Specchio L (April 2011). "The adverse event profile of pregabalin: a systematic review and meta-analysis of randomized controlled trials". Epilepsia. 52 (4): 826–36. doi:10.1111/j.1528-1167.2010.02966.x. PMID 21320112.

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