Use of a new antiepileptic drug or an old one as first drug for treatment of absence epilepsy

Epilepsia - Tập 50 Số s8 - Trang 37-41 - 2009
Patricia Penovich1, L. James Willmore
1Minnesota Epilepsy Group PA, University of Minnesota School of Medicine, USA.

Tóm tắt

SummaryTreatment of absence epilepsy requires understanding the efficacy and side effects of several drugs, one of which first became available more than 50 years ago. Methods for drug development and procedures for evaluating their safety and efficacy over that time have changed dramatically. Observational studies of the efficacy of ethosuximide, a drug developed in the 1950s, reported complete seizure control in 40–60% of patients. Valproic acid, a drug with a broad spectrum of effect, showed robust efficacy as well for control of absence seizures. Because side effects limit use in some patients, newer drugs were evaluated in patients with absence seizures. Of drugs becoming available in the last 15 years, lamotrigine has some effect in absence seizures. Although older and newer drugs presently are used without the rigorous underpinnings of the highest quality of evidence, our analysis found that ethosuximide, valproate, and lamotrigine are effective in the treatment of absence seizures, with ethosuximide quite possibly being the first drug of choice.

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Tài liệu tham khảo

Arzimanoglou A, 2001, Optimal use of lamotrigine in clinical practice: results of an open multicenter trial in refractory epilepsy, Rev Neurol (Paris), 157, 525

10.1111/j.1528-1157.1993.tb02395.x

10.1111/j.1528-1157.1998.tb01332.x

10.1212/WNL.52.7.1330

10.1212/WNL.25.6.515

10.1016/S0387-7604(99)00023-6

10.1001/archneur.61.10.1604

10.1111/j.0013-9580.2004.40903.x

10.1016/S0387-7604(03)00090-1

10.1053/seiz.2001.0655

10.1016/S0028-3908(00)00051-4

10.1212/WNL.37.3.379

10.1046/j.1528-1157.2001.4220230.x

10.1016/S0887-8994(97)00010-6

10.1111/j.1600-0404.1995.tb00434.x

10.1111/j.1528-1157.1999.tb00805.x

10.1001/jama.1962.03050230042017b

10.1016/j.seizure.2004.04.003

10.1016/S0920-1211(96)00031-9

10.1111/j.1528-1157.1964.tb04349.x

10.1016/S1059-1311(03)00139-0

10.1016/j.seizure.2003.06.001

10.1016/S0140-6736(84)90557-9

10.1056/NEJMoa0803531

10.1111/j.1528-1157.1994.tb02920.x

10.1212/01.wnl.0000297512.18364.40

10.2165/00128072-200103050-00006

10.1212/WNL.32.2.157

10.1212/WNL.28.9.886

10.1016/j.eplepsyres.2005.02.006

10.1212/WNL.28.9.961

10.1016/j.seizure.2004.04.018

10.1016/j.seizure.2004.04.021

10.1212/WNL.8.10.769