To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: DG DISPATCH - AAP: New Antiepileptic Drugs For Children URL: http://www.pslgroup.com/dg/1E948E.htm Doctor's Guide November 2, 2000
By Lara Pullen Special to DG News
CHICAGO, IL -- November 2, 2000 -- Drug therapy remains the mainstay of antiepileptic therapy, according to a review of new treatments currently available in the United States.
Dr. James W. Wheless of the University of Texas, in Houston, provided an update on these newer antiepileptic drugs (AED) and their role in the pediatric population at the American Academy of Pediatrics (AAP) Annual Meeting in Chicago, Illinois.
The goal of therapy is to relieve all seizures while at the same time providing a safe medication for the patient. To that end, nine new drugs have recently been introduced into the United States market: felbamate, gabapentin, lamotrigine, topiramate, tiagabine, levetiracetam, oxcarbazepine and zonisamide. A new drug, vigabatrin, shows promise but has is not currently available in the U.S.
The first step when making a prescription decision is to determine the nature of the seizure that the child is having. Drugs such as felbamate, lamotrigine and topiramate are broad spectrum and can be used to treat numerous seizure types. Other drugs, such as gabapentin, tiagabine and oxcarbazepine can be described as "niche drugs", because their efficacy is largely limited to specific types of seizures.
In some cases, the drug must be introduced immediately into the child's system. This requires intravenous (IV) loading and requires drugs whose pharmacokinetic profile allows for rapid introduction. Drugs suitable for IV use include the older drugs, such as fosphenytoin, valproate and phenobarbital. Many of the newer drugs, such as zonisamide, topiramate and lamotrigine require several weeks to reach the maintenance dose.
Finally, Dr. Wheless said, physicians should consider the safety profile of each drug when choosing a treatment. He described gabapentin as one of the safest medications available for the treatment of epilepsy. The newest drugs (oxcarbazepine, levetiracetam and tiagabine) also appear to be safe, although they have more limited patient exposure. Felbamate and lamotrigine have safety concerns that make them poorer choices for first line therapy. --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.