NEW DEVELOPMENTS IN THE SEARCH FOR IMPROVED ANTIEPILEPTIC DRUGS

Recent advances in neurobiology have yielded clues about the abnormal physiology of epilepsy and a better understanding of the action of the established anticonvulsants, which were discovered fortuitously or in animal screening tests. Some newer antiepileptic drugs may represent an important improvement over existing therapy, especially if they sho w efficacy in patients with intractable seizures or fewer limiting neu rological side effects. Many developmental agents are designed to inte ract with a specific target and employ one of three strategies: enhanc ement of central inhibition; diminution of central excitation; or modu lation of ionic channels regulating neuronal excitability. This articl e reviews the anticonvulsant compounds in development, with a focus on those being investigated in man. Updated information is also provided about the mechanisms of action of the antiepileptic drugs presently u sed as first line therapy.