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 Epile

Abstract:

OBJECTIVE:To assess the evidence demonstrating efficacy, tolerability, and safety of seven new antiepileptic drugs (AEDs) (gabapentin, lamotrigine, topiramate, tiagabine, oxcarbazepine, levetiracetam, and zonisamide) in the treatment of children and adults with refractory partial and generalized epilepsies. METHODS:A 23-member committee including general neurologists, pediatric neurologists, epileptologists, and doctors in pharmacy evaluated the available evidence based on a structured literature review including MEDLINE, Current Contents, and Cochrane library for relevant articles from 1987 until March 2003. RESULTS:All of the new AEDs were found to be appropriate for adjunctive treatment of refractory partial seizures in adults. Gabapentin can be effective for the treatment of mixed seizure disorders, and gabapentin, lamotrigine, oxcarbazepine, and topiramate for the treatment of refractory partial seizures in children. Limited evidence suggests that lamotrigine and topiramate are also effective for adjunctive treatment of idiopathic generalized epilepsy in adults and children, as well as treatment of the Lennox Gastaut syndrome. CONCLUSIONS:The choice of AED depends upon seizure and/or syndrome type, patient age, concomitant medications, AED tolerability, safety, and efficacy. The results of this evidence-based assessment provide guidelines for the prescription of AEDs for patients with refractory epilepsy and identify those seizure types and syndromes where more evidence is necessary.

journal_name

Neurology

journal_title

Neurology

authors

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 Jr,Turk WR,Fischer JH,Bourgeois B,Wilner A,Faught R

doi

10.1212/01.wnl.0000123695.22623.32

subject

Has Abstract

pub_date

2004-04-27 00:00:00

pages

1261-73

issue

8

eissn

0028-3878

issn

1526-632X

journal_volume

62

pub_type

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