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Second Generation Anticonvulsants: Gabapentin, Lamotrigene, Leveticetam, and Topiramate

Critical Care Toxicology

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Abstract

The second generation anticonvulsants are generally considered to be the nonbenzodiazepine antiepileptic medications approved by the US Food and Drug Administration (FDA) after 1967 when valproic acid was marketed. There was a surge of newer anticonvulsant pharmaceuticals approved for clinical use, starting with vigabatrin in the late 1980s and continued throughout the 1990s (oxcarbazine, lamotrigine, gabapentin, felbamate, topiramate, tiagabine, fosphenytoin, levetiracetam, and zonisamide). Discontinuation of some of these pharmaceuticals in the USA and other countries has already occurred due to the decisions of the manufacturer, FDA, and other regulatory authorities, secondary to side effects and clinicians choosing more efficacious options.

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Authors and Affiliations

  1. Department of Emergency Medicine, Toxicology, Virginia Commonwealth University, Richmond, VA, USA

    M. P. Emswiler

  2. Department of Emergency Medicine, Division of Clinical Toxicology , Virginia Commonwealth University, Richmond, VA, USA

    K. L. Cumpston

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  1. M. P. Emswiler
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Correspondence to M. P. Emswiler .

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Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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Emswiler, M.P., Cumpston, K.L. (2016). Second Generation Anticonvulsants: Gabapentin, Lamotrigene, Leveticetam, and Topiramate. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_41-1

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  1. Latest

    Second Generation Anticonvulsants: Gabapentin, Lamotrigine, Levetiracetam, and Topiramate
    Published:
    12 January 2017

    DOI: https://doi.org/10.1007/978-3-319-20790-2_41-2

  2. Original

    Second Generation Anticonvulsants: Gabapentin, Lamotrigene, Leveticetam, and Topiramate
    Published:
    18 October 2016

    DOI: https://doi.org/10.1007/978-3-319-20790-2_41-1

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