NEW ANTIEPILEPTIC DRUGS

Notwithstanding pharmacokinetics has greatly increased the rational ap proach to the drug treatment of epilepsies, about 25% of the patients do not respond to the therapy. Therefore, a great effort has been made to discover new antiepileptic drugs effective in refractory seizures. On the basis of increased knowledge of seizure pathophysiology two pr incipal groups of drugs have been developed: the first enhancing brain GABA activity (vigabatrin); the second inhibiting excitatory amino-ac ids (lamotrigine and felbamate). Oxcarbazepine has the same mechanism of action as carbamazepine, whereas gabapentin's mechanism is still un certain. The major clinical indications of these new antiepileptic dru gs are represented by partial complex seizures. Side effects (mostly r egarding the central nervous system) appear mild, and clinical interac tions have little importance. The role of therapeutic drug monitoring for these substances is at present not well established.