THERAPEUTIC RELEVANCE AND DYNAMICS OF NEW ANTIEPILEPTIC DRUGS

Authors
Citation
B. Pohlmanneden, THERAPEUTIC RELEVANCE AND DYNAMICS OF NEW ANTIEPILEPTIC DRUGS, Nervenheilkunde, 12(5), 1993, pp. 179-186
Citations number
72
Categorie Soggetti
Neurosciences,Psychiatry
Journal title
ISSN journal
07221541
Volume
12
Issue
5
Year of publication
1993
Pages
179 - 186
Database
ISI
SICI code
0722-1541(1993)12:5<179:TRADON>2.0.ZU;2-9
Abstract
Epilepsy is one of the most common neurological disorders with a preva lence rate of 0.5-1%. Nowadays, antiepileptic drugs are developed rati onally from an understanding of basic mechanisms in epileptogenesis an d neurotransmitters rather than from an empirical screening program as in the past. The most promising drugs are presented: Lamotrigine, a f olate-antagonist, reduces the release of excitatoric neurotransmitter glutamate. 30% of drug resistant epileptic patients showed an improvem ent of seizure frequency with a reduction of more than 50%. There was a remarkable effect on primary generalized seizures. Oxcarbazepin (OXC ), the 10-ketoanalogon of Carbamazepin (CBZ) presented with the same e xcellent anticonvulsive action like CBZ, but had significantly less si de effects because of its different metabolic pathways. Since the hepa tic microsomal systems is not involved during metabolisation, there is no relevant auto- or heteroinduction, so that this drug should be the first choice for any comedication. Gamma-Vinyl-GABA (Vigabatrin), a > >designer drug<<, is a selective irreversible inhibitor of GABA-transa minase leading to a long persisting increase of the inhibitory GABA ne urotransmitter in the central nervous system with high efficacy in com plex-partial seizures. Relevant side effects are a reversible toxic my elin edema in animal experiments and the activation of psychosis in a defined risk population.