In the past two years, three new antiepileptic drugs gabapentin, lamotrigine, and felbamate have been approvedfor use in the United States. They are the first such drugsto be approved since valproic acid, in 1978. These three drugsand others now in use in Europe, Canada, or Japan or being testedin trials in the United States reflect the resurgence of interestin developing new drugs for the treatment of epilepsy. Thisarticle reviews the pharmacologic characteristics of these newdrugs, indications for their use, side effects, and appropriateregimens.
Antiepileptic Drugs Recently Approved in the United States
Gabapentin
Lamotrigine
Felbamate
Antiepileptic Drugs Available in Europe, Canada, or Japan or Being Tested in the United States
Clobazam
Vigabatrin
Oxcarbazepine
Zonisamide
Tiagabine
Topiramate
Other New Antiepileptic Drugs
Current Recommendations for Use
Source Information
From the Department of Neurology, University of Pennsylvania, Philadelphia (M.A.D.), and the Epilepsy Research Unit, University Department of Medicine and Therapeutics, Western Infirmary, Glasgow, Scotland (M.J.B.).
Address reprint requests to Dr. Dichter at the Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
Sethi, M. A., Mehta, R., Devanand, D. P.
(2003). Gabapentin in Geriatric Mania. J Geriatr Psychiatry Neurol
16: 117-120
[Abstract]
Pandley, P., Shah, J., Juhasz, C., Pfund, Z., Chugani, H. T.
(2002). Spontaneous Long-Term Remission of Intractable Partial Epilepsy in Childhood. J Child Neurol
17: 466-470
[Abstract]
Sills, G. J., Patsalos, P.N., Butler, E., Forrest, G., Ratnaraj, N., Brodie, M.J.
(2001). Visual field constriction: Accumulation of vigabatrin but not tiagabine in the retina. Neurology
57: 196-200
[Abstract][Full Text]
Ferrier, I N.
(2001). Developments in mood stabilisers: Depression and public health. Br Med Bull
57: 179-192
[Abstract][Full Text]
Morello, C. M., Leckband, S. G., Stoner, C. P., Moorhouse, D. F., Sahagian, G. A.
(1999). Randomized Double-blind Study Comparing the Efficacy of Gabapentin With Amitriptyline on Diabetic Peripheral Neuropathy Pain. Arch Intern Med
159: 1931-1937
[Abstract][Full Text]
Devinsky, O.
(1999). Patients with Refractory Seizures. NEJM
340: 1565-1570
[Full Text]
Stephen, L. J, Maxwell, J. E, Brodie, M. J
(1999). Drug points: Transient hemiparesis with topiramate. BMJ
318: 845-845
[Full Text]
Feely, M.
(1999). Fortnightly review: Drug treatment of epilepsy. BMJ
318: 106-109
[Full Text]
Sillanpaa, M., Jalava, M., Kaleva, O., Shinnar, S.
(1998). Long-Term Prognosis of Seizures with Onset in Childhood. NEJM
338: 1715-1722
[Abstract][Full Text]
Schmidt, W. K.
(1998). Drug Development for Disorders of the Nervous System: Challenge and Opportunity at the Pharmaceutical-Biotech-Academic Interface. Neuroscientist
4: 9-13
[Abstract]
Brodie, M. J, Elferink, A J A, Zwieten-Boot, B J V., Craig, J. J, Morrow, J. I, Wong, I. C
(1997). New antiepileptic drugs. BMJ
314: 602-602
[Full Text]
Dennis, C. St., Synoground, G.
(1997). Anticonvulsant Medications: New Drug Update. The Journal of School Nursing
13: 22-28
[Abstract]