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Titolo:
THE NEW-GENERATION OF ANTIEPILEPTIC DRUGS - ADVANTAGES AND DISADVANTAGES
Autore:
PERUCCA E;
Indirizzi:
UNIV PAVIA,DEPT INTERNAL MED & THERAPEUT,CLIN PHARMACOL UNIT,PIAZZA BOTTA 10 I-27100 PAVIA ITALY
Titolo Testata:
British journal of clinical pharmacology
fascicolo: 5, volume: 42, anno: 1996,
pagine: 531 - 543
SICI:
0306-5251(1996)42:5<531:TNOAD->2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEWLY-DIAGNOSED EPILEPSY; CLINICAL PHARMACOKINETICS; VALPROIC ACID; PHARMACOLOGICAL PROPERTIES; ANTICONVULSANT DRUGS; SODIUM VALPROATE; LAMOTRIGINE; CARBAMAZEPINE; VIGABATRIN; ZONISAMIDE;
Keywords:
ANTIEPILEPTIC DRUGS; FELBAMATE; GABAPENTIN; LAMOTRIGINE; OXCARBAZEPINE; TIAGABINE; TOPIRAMATE; VIGABATRIN; ZONISAMIDE;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
76
Recensione:
Indirizzi per estratti:
Citazione:
E. Perucca, "THE NEW-GENERATION OF ANTIEPILEPTIC DRUGS - ADVANTAGES AND DISADVANTAGES", British journal of clinical pharmacology, 42(5), 1996, pp. 531-543

Abstract

1 After a hiatus of over 20 years, several new antiepileptic drugs (vigabatrin, lamotrigine, gabapentin, oxcarbazepine, topiramate, felbamate, zonisamide and tiagabine) have reached or approached the registration phase. 2 Compared with older agents, many new drugs exhibit simpler pharmacokinetics. This is especially true for vigabatrin and gabapentin, which are renally eliminated and have a low interaction potential. 3 Unlike most of the older agents, vigabatrin, lamotrigine, gabapentin and tiagabine are devoid of significant enzyme inducing or inhibiting properties. Topiramate, oxcarbazepine and felbamate may induce the metabolism of steroid oral contraceptives. In addition, felbamate alsoacts as a metabolic inhibitor. 4 To date, the efficacy of new drugs has been evaluated extensively only under add-on conditions in patientswith partial seizures (with or without secondary generalization) refractory to conventional treatment. However, there is evidence that lamotrigine, zonisamide, felbamate and, possibly, topiramate may also be effective in generalized epilepsies. 5 In placebo-controlled studies, typically between 15 and 40% of patients with difficult-to-treat partial epilepsy have shown an improvement (defined as a 50% or greater decrease in seizure frequency) after addition of a new drug. Only a small minority of these patients achieved complete seizure control. 6 Compared with older agents, some of the new drugs may have a better tolerability profile. Felbamate, however, has been associated with a high riskof aplastic anaemia and hepatotoxicity. 7 At present, the main use ofthe new agents is in patients refractory to first-line drugs such as carbamazepine or valproate, and further studies are required to characterize their activity spectrum as well as their potential value in monotherapy. In most patients, new drugs cannot be recommended for first-line use until evidence is obtained that potential advantages in tolerability or ease of use outweigh the drawback of their high cost.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 18:59:48