New antiepileptic drugs

Abstract

After 1977, no new antiepileptic drugs (AEDs) were available until felbamate was approved in 1993. Since then, three more new AEDs have been approved for use in the United States: gabapentin, lamotrigine, and topiramate. These new medications have greatly improved the medical treatment of epilepsy. Gabapentin is indicated for the treatment of partial and secondarily generalized seizures in adults. It has proven to be a safe, well-tolerated medication and is also beneficial in treating pain syndromes. Lamotrigine and topiramate are approved for partial and secondarily generalized seizures in adults, and, both likely have a broader spectrum of action, with efficacy against primary generalized seizures and seizures that occur with Lennox-Gastaut syndrome. Both must be slowly titrated due to their potential side effects, lamotrigine to avoid rash and topiramate to avoid cognitive impairment. Serious rash from lamotrigine occurs at a higher rate in children than in adults.