J Korean Med Assoc.  2003 Apr;46(4):287-297. 10.5124/jkma.2003.46.4.287.

Epilepsy : Drug Treatment

Affiliations
  • 1Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Korea. kheo@yumc.yonsei.ac.kr

Abstract

The prognosis of epilepsy has improved considerably, and about 80% of patients can now be expected to achieve complete seizure control with antiepileptic drug treatment. It is important to understand that the response to individual drugs may vary considerably in relation to the seizure type or epilepsy syndrome, so that optimization of treatment requires careful individualization of the dosage, and that rational polytherapy should be performed in consideration of the mechanisms of action of antiepileptic drugs, adverse effects, and drug interactions. Although newly developed antiepileptic drugs have some advantages in terms of adverse effects and pharmacokinetics compared with traditional antiepileptic drugs, they have demonstrated no significant difference in efficacy in comparative studies. The purpose of this chapter is to review the basic principles, which should guide the optimal treatment with antiepileptic drugs in patients with epilepsy.

Keyword

Monotherapy; Combination therapy; Pharmacokinetics; Toxicity

MeSH Terms

Anticonvulsants
Drug Interactions
Epilepsy*
Humans
Pharmacokinetics
Prognosis
Seizures
Anticonvulsants

Reference

1. Deckers CL, Genton P, Sills GJ, Schmidt D. Current limitations of antiepileptic drug therapy: a conference review. Epilepsy Res. 2003. 53:1–17.
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2. Marson AG, Kadir ZA, Hutton JL, Chadwick DW. The new antiepileptic drugs: a systemic review of their efficacy and tolerability. Epilepsia. 1997. 38:859–880.
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3. Marson AG, Williamson PR, Clough H, Hutton JL, Chadwick DW. Epilepsy Monotherapy Trial Group. Carbamazepine versus valproate monotherapy for epilepsy: a meta-analysis. Epilepsia. 2002. 43:505–513.
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4. Patsalos PN, Froscher W, Pisani F, van Rijn CM. The importance of drug interactions in epilepsy therapy. Epilepsia. 2002. 43:365–385.
Article
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