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Anti-convulsant Agents: Felbamate

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NeuroPsychopharmacotherapy

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Abstract

Felbamate was marketed in the USA in 1993 after undergoing blinded randomized controlled trials as adjunctive therapy for focal seizures and in patients with Lennox–Gastaut syndrome, as well as monotherapy for focal seizures. It appears to have a broad spectrum of efficacy. Felbamate is metabolized in the liver, so that its clearance is increased by enzyme inducers. It has a number of interactions as a result of inhibition of CYP2C19 and induction of CYP3A4. Its adverse effects are mostly referable to the central nervous system and the gastrointestinal system; they improved considerably with simplification of the medication regimen and conversion to monotherapy. Felbamate’s clinical use was markedly reduced by the appearance of serious idiosyncratic toxicity, including aplastic anemia and liver failure. As a result, it is not recommended as initial therapy and its potential benefit must justify the associated risk. Since idiosyncratic adverse effects usually appeared after a latency of several months, a short course of felbamate can be considered in patients with severe epilepsy that has not responded to antiseizure medications.

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Authors and Affiliations

  1. Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA

    Bassel Abou-Khalil

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  1. Bassel Abou-Khalil
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Correspondence to Bassel Abou-Khalil .

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Editors and Affiliations

  1. Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany

    Peter Riederer

  2. Institute of Psychological Medicine (IPM), Soyen, Germany

    Gerd Laux

  3. Centre for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Germany

    Christian Riederer

Section Editor information

  1. Beta Neurology – Competence Center for Epilepsy, Beta Klinik GmbH, Bonn, Germany

    Christian E. Elger FRCP

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Abou-Khalil, B. (2022). Anti-convulsant Agents: Felbamate. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_297

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  • DOI: https://doi.org/10.1007/978-3-030-62059-2_297

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-62058-5

  • Online ISBN: 978-3-030-62059-2

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