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Place of Newer Antiepileptic Drugs in the Treatment of Epilepsy

  • Practical Therapeutics
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Summary

There are several new antiepileptic drugs undergoing extensive clinical investigation. Five new drugs — vigabatrin, lamotrigine, gabapentin, felbamate and oxcarbazepine — appear to be the most widely tested and promising agents.

Vigabatrin is most effective in drug-resistant partial epilepsy. Vigabatrin is also effective in infantile spasms, but seems to have negative effects on myoclonic epilepsies and absence seizures. Lamotrigine and felbamate seem to be effective in partial epilepsy and in Lennox-Gastaut syndrome. In addition, lamotrigine and felbamate seem to have efficacy in idiopathic generalised epilepsies. Oxcarbazepine appears to be equally as effective as carbamazepine, but less toxic. Gabapentin has few adverse effects and has efficacy in some patients with drug-resistant partial epilepsy.

Some of the new antiepileptic drugs modify excitatory or inhibitory amino acid transmission, but some of them may employ new, still unknown mechanisms of action. Depending on the mechanism of action, the therapeutic effectiveness of the antiepileptic drugs may differ in specific epileptic syndromes. Future antiepileptic drugs may thus give us the possibility to design rational polypharmacy for individual patients by combining agents with different spectra of effectiveness. Considering the goal of good tolerability in the development of the new antiepileptic drugs, polypharmacy with these agents is not expected to increase adverse effects significantly.

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References

  • Abou-Khalil B, Shellenberger MK, Anhut H. Two open-label multicenter studies of gabapentin in patients with refractory epilepsy. Abstract. Epilepsia 33: 77, 1992

    Google Scholar 

  • Äikiä M, Kälviäinen R, Sivenius J, Halonen T, Riekkinen PJ. Cognitive effects of oxcarbazepine and phenytoin monotherapy in newly diagnosed epilepsy: one year follow-up. Epilepsy Research 11: 199–203, 1992

    Article  PubMed  Google Scholar 

  • Albani F, Theodore WH, Washington P, Devinsky O, Bromfield E, et al. Effect of felbamate on plasma levels of carbamazepine and its metabolites. Epilepsia 32: 130–132, 1991

    Article  CAS  PubMed  Google Scholar 

  • Allen E, Jawad S, Wrae S, Richens A. Does the anticonvulsant gabapentin lack enzyme inducing proerties? Abstract. 17th International Epilepsy Congress, Jerusalem, 1987

  • Arezzo JC, Schroeder CE, Litwak MS, Steward DL. Effects of vigabatrin on evoked potential in dogs. British Journal of Clinical Pharmacology 27: 53S–60S, 1989

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Baltzer V, Schmutz M. Experimental anticonvulsive properties of GP 47 680 and GP 47 779, its main human metabolite: compound related to carbamazepine. Advances in Epileptology: 295–299, 1977

  • Bartoszyk GD, Meyerson N, Reimann W, Satzinger G, von Hodenberg A. New anticonvulsant drugs: gabapentin. In Meldrum & Porter (Eds) Current problems in epilepsy, Vol. 4, pp. 147–163, John Libbey, London, 1986

    Google Scholar 

  • Battino D, Croci D, Granata T, Bernardi G, Monza G. Changes in unbound and total valproic acid concentrations after replacament of carbamazepine with oxcarbazepine. Therapeutic Drug Monitoring 14: 376–379, 1992

    Article  CAS  PubMed  Google Scholar 

  • Bauer G, Bechinger D, Castell M, Deisenhammer E, Egli M, et al. Gabapentin in the treatment of drug-resistant epileptic patients. Advances in Epileptology 17: 219–221, 1989

    Google Scholar 

  • Ben-Menachem E, Persson LI, Schechter PJ, Haegele KD, Huebert N, et al. Effects of single doses of vigabatrin on CSF concentrations of GABA, homocarnosine, homovanillic acid and 5-hydroxyindolacetic acid in patients with complex partial epilepsy. Epilepsy Research 2: 96–101, 1988

    Article  CAS  Google Scholar 

  • Betts T. Clinical use of lamotrigine. Seizure 1: 3–6, 1992

    Article  CAS  PubMed  Google Scholar 

  • Betts T, Goodwin G, Withers RM, Yuen AWC. Human safety of lamotrigine. Epilepsia 32: 17–21, 1991

    Article  Google Scholar 

  • Binnie C. An overview: efficacy of lamotrigine. International Clinical Practice Series, No. 2, pp. 31–37, 1992

    Google Scholar 

  • Binnie CD, Debets RMC, Engelman M. Double-blind crossover trial of lamotrigine as add-on therapy in intractable epilepsy. Epilepsy Research 4: 222–229, 1989

    Article  CAS  PubMed  Google Scholar 

  • Bourgeois B, Leppik IE, Sackellares JC, Laxer K, Lesser R, et al. Felbamate: a double-blind controlled trial in patients undergoing presurgical evaluation of partial seizures. Neurology 43: 693–696, 1993

    Article  CAS  PubMed  Google Scholar 

  • Brodie MJ. Lamotrigine. Lancet 339: 1397–1400, 1992

    Article  CAS  PubMed  Google Scholar 

  • Browne TR. Long-term efficacy and toxicity of gabapentin. Abstract. Neurology 43: 307, 1993

    Google Scholar 

  • Browne TR, Mattson RH, Penry JK, Smith DB, Treiman DM, et al. Vigabatrin for refractory complex partial seizures: multicenter single-blind study with long-term follow-up. Neurology 37: 184–189, 1987

    Article  CAS  PubMed  Google Scholar 

  • Browne TR, Mattson RH, Penry JK, Smith DB, Treiman DM, et al. Multicenter long-term safety and efficacy study of vigabatrin for refractory complex partial seizures: an update. Neurology 41: 363–364, 1991

    Article  CAS  PubMed  Google Scholar 

  • Bruni J, Saunders M, Anhut H, Sauermann W. Efficacy and safety of gabapentin (Neurontin): a multicenter, placebo-controlled, double-blind study. Abstract. Neurology 41: 330, 1991

    Article  Google Scholar 

  • Cannon DJ, Butler WH, Mumford JP, Lewis PJ. Neuropathological findings in patients receiving long-term vigabatrin therapy for chronic intractable epilepsy. Journal of Child Neurology 6: 17–24, 1991

    Article  Google Scholar 

  • Cheung H, Kamp D, Harris E. An in vitro investigation of the action of lamotrigine on neuronal voltage-activated sodium channels. Epilepsy Research 13: 107–112, 1992

    Article  CAS  PubMed  Google Scholar 

  • Chiron C, Dulac O, Beaumont D, Palacios L, Pajot N, et al. Therapeutic trial of vigabatrin in refractory infantile spasms. Journal of Child Neurology 6: 52–59, 1991

    Article  Google Scholar 

  • Cohen AF, Land GS, Breimer DD, Yuen WC, Winton C, et al. Lamotrigine, a new anticonvulsant: pharmacokinetics in noraml humans. Clinical Pharmacology and Therapeutics 42: 535–541, 1987

    Article  CAS  PubMed  Google Scholar 

  • Collaborative Group for the Study of Epilepsy. Prognosis of epilepsy in newly referred patients: a multicenter prospective study of the effects of monotherapy on the long-term course of epilepsy. Epilepsia 33: 45–51, 1992

    Article  Google Scholar 

  • Comstock TI, Sica DA, Bockbrader HN, Underwood BA, Sedman AJ. Gabapentin pharmacokinetics in subjects with various degrees of renal function. Abstract. Journal of Clinical Pharmacology 30: 831, 1990

    Google Scholar 

  • Cosi V, Callieco R, Calimberti CA, Manni R, Tartara A, et al. Effects of vigabatrin on evoked potentials in epileptic patients. British Journal of Clinical Pharmacology 27: 61–68, 1989

    Article  Google Scholar 

  • Crawford P, Ghadiali E, Lane R, Blumhardt L, Chadwick D. Gabapentin as an antiepileptic drug in man. Journal of Neurology, Neurosurgery, and Psychiatry 50: 682–686, 1987

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Dam M. Long-term evaluation of vigabatrin (gamma-vinyl GABA) in epilepsy. Epilepsia 30: 26–30, 1989

    Article  Google Scholar 

  • Dam M, Ekberg R, Löyning Y, Waltimo O, Jakobsen K. A double-blind study comparing oxcarbazepine and carbamazepine in patients with newly diagnosed, previously untreated epilepsy. Epilepsy Research 3: 70–76, 1989

    Article  CAS  PubMed  Google Scholar 

  • Dickinson RG, Hooper WD, Dunstan PR, Eadie MJ. First dose and steady-state pharmacokinetics of oxcarbazepine and its 10-hydroxy metabolite. European Journal of Clinical Pharmacology 37: 69–74, 1989

    CAS  PubMed  Google Scholar 

  • Dodrill CB, Arnett J, Sommerville K, Sussman N. Evaluation of the effects of vigabatrin upon cognition and quality of life in epilepsy. Abstract. Neurology 43: 306, 1993

    Google Scholar 

  • Dodrill CB, Wilensky AJ, Ojeman L, Temkin N, Shellenberger K, et al. Neuropsychological, mood and psychosocial effects of gabapentin. Epilepsia 33: 117–118, 1992

    Article  Google Scholar 

  • Eldon MA, Underwood BA, Randinitis EJ, Posvar EL, Sedman AJ. Lack of effect of gabapentin on the pharmacokinetics of a noretihindrone acetate/ethinyl estradiol-containing oral contraceptive. Abstract. Neurology 43: 307, 1993

    Google Scholar 

  • Elwes RDC, Johnson AL, Shorvon SD, Reynolds EH. The prognosis for seizure control in newly diagnosed epilepsy. New England Journal of Medicine 311: 944–947, 1984

    Article  CAS  PubMed  Google Scholar 

  • Devinsky O, Kothari M, Rubin R, Mercandetti R, Luciano D. Felbamate for absence seizures. Abstract. Epilepsia 33: 84, 1992

    Article  Google Scholar 

  • Faught ER, Leroy RF, Messenheimer JA, Matsuo F, Bergen D, et al. Clinical experience with lamotrigine (‘Lamictal’) monotherapy for partial seizures in adult outpatients. Abstract. Epilepsia 33: 82, 1992

    Google Scholar 

  • Faught E, Sachdeo RC, Remler MP, Chayasirisobhon S, Iragui-Madoz VJ, et al. Felbamate monotherapy for partial-onset seizures: an active-control trial. Neurology 43: 688–692, 1993

    Article  CAS  PubMed  Google Scholar 

  • Felbamate Study Group in Lennox-Gastaut syndrome. Efficacy of felbamate in childhood epileptic encephalopathy (Lennox-Gastaut syndrome). New England Journal of Medicine 328: 29–33, 1993

    Article  Google Scholar 

  • Friis ML, Kristensen O, Boas J, Dalby M, Deth SH, et al. Therapeutic experiences with 947 epileptic out-patients in oxcarbazepine treatment. Acta Neurologica Scandinavica 87: 224–227, 1993

    Article  CAS  PubMed  Google Scholar 

  • Frisk-Holmberg M, Keith P, Meyer Ph. Effect of food on the absorption of vigabatrin. British Journal of Clinical Pharmacology 27: 23–25, 1989

    Article  Google Scholar 

  • Fuerst RH, Graves NM, Leppik IE, Brundage RC, Holmes GB, et al. Felbamate increases phenytoin but decreases carbamazepine concentrations. Epilepsia 29: 488–491, 1988

    Article  CAS  PubMed  Google Scholar 

  • Gibson JP, Yarrington JT, Loudy DE, Gerbig CG, Hurst GH, et al. Chronic toxicity studies with vigabatrin, a GABA-transaminase inhibitor. Toxicologic Pathology 18: 225–238, 1990

    Article  CAS  PubMed  Google Scholar 

  • Goa KL, Sorkin EM. Gabapentin: a review of its pharmacological proerties and clinical potential in epilepsy. Drugs 46: 409–427, 1993

    Article  CAS  PubMed  Google Scholar 

  • Goa KL, Ross SR, Chrisp P. Lamotrigine: a review of its pharmacological properties and clinical efficacy in epilepsy. Drugs 46: 152–176, 1993

    Article  CAS  PubMed  Google Scholar 

  • Grant SM, Faulds D. Oxcarbazepine: a review of its pharmacology and therapeutic potential in epilepsy, trigeminal neuralgia and affective disorders. Drugs 43: 873–888, 1991

    Article  Google Scholar 

  • Grant SM, Heel RC. Vigabatrin: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in epilepsy and disorders of motor control. Drugs 41: 889–926, 1991

    Article  CAS  PubMed  Google Scholar 

  • Graves NM, Holmes GB, Leppik E, Rask C, Slavin M, et al. Pharmacokinetics of gabapentin in patients treated with phenytoin. Abstract. Pharmacotherapy 9: 196, 1989

    Google Scholar 

  • Haegele KD, Huebert ND, Ebel M, Tell GP, Schechter PJ. Pharmacokinetics of vigabatrin: implications of creatinine clearance. Clinical Pharmacology and Therapeutics 44: 558–565, 1988

    Article  CAS  PubMed  Google Scholar 

  • Haegele KD, Schechter PJ. Kinetics of the enantiomers of vigabatrin after an oral dose of racemate or the active S-enantiomer. Clinical Pharmacology and Therapeutics 40: 581–585, 1986

    Article  CAS  PubMed  Google Scholar 

  • Halonen T, Lehtinen M, Pitkänen A, Ylinen A, Riekkinen PJ. Inhibitory and excitatory amino acids in CSF of patients suffering from complex partial seizures during chronic treatment with gamma-vinyl GABA (vigabatrin). Epilepsy Research 2: 246–252, 1988

    Article  CAS  PubMed  Google Scholar 

  • Hill DR, Suman-Chauhan N, Woodruff GN. Autoradiographical detection of [3H]-gabapentin binding sites in rodent brain. Abstract. British Journal of Clinical Pharmacology 104: 72, 1991

    Google Scholar 

  • Holdich T, Whiteman P, Orme M, Back D, Ward S. Effects of lamotrigine on the pharmacology of the combined oral contraceptive pill. 19th International Epilepsy Congress, Rio de Janeiro, October 14–19, 1991. Abstract. Epilepsia 32 (Suppl. 1): 96, 1991

    Google Scholar 

  • Hooper WD, Kavanagh MC, Herkes GK, Eadie MJ. Lack of pharmacokinetic interaction between phenobarbitone and gabapentin. British Journal of Clinical Pharmacology 31: 171–174, 1991

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Houtkooper MA, Lammertsma A, Meye JWA, Goedhart DM, Meinardi H, et al. Oxcarbazepine (GP 47.680): a possible alternative to carbamazepine? Epilepsia 28: 693–698, 1987

    Article  CAS  PubMed  Google Scholar 

  • Jawad S, Richens A, Goodwin G, Yuen WC. Controlled trial of lamotrigine (‘Lamictal’) for refractory partial seizures. Epilepsia 30: 356–363, 1989

    Article  CAS  PubMed  Google Scholar 

  • Kälviäinen R, Äikiä M, Riekkinen PJ. Gamma-vinyl GABA (Vigabatrin) monotherapy: efficacy, safety and cognitive profile during two-year follow-up. Abstract. Epilepsia 33: 118, 1992

    Google Scholar 

  • Kälviäinen R, Halonen T, Pitkänen A, Riekkinen PJ. Amino acid levels in the cerebrospinal fluid of newly diagnosed epileptic patients: effect of vigabatrin and carbamazepine monotherapies. Journal of Neurochemistry 60: 1244–1250, 1993

    Article  PubMed  Google Scholar 

  • Keränen T, Jolkkonen J, Jensen PK, Menge GP, Andersson P. Absence of interaction between oxcarbazepine and erythromycin. Acta Neurologica Scandinavica 86: 120–123, 1992a

    Article  PubMed  Google Scholar 

  • Keränen T, Jolkkonen J, Klosterskov-Jensen P, Menge GP. Oxcarbazepine does not interact with cimetidine in healthy volunteers. Acta Neurologica Scandinavica 85: 239–242, 1992b

    Article  PubMed  Google Scholar 

  • Keränen T, Riekkinen P. Severe epilepsy: diagnostic and epidemiological aspects. Acta Neurologica Scandinavica 78: 7–14, 1988

    Article  Google Scholar 

  • Klosterskov Jensen P, Saano V, Haring P, Svenstrup B, Menge GP. Possible interaction between oxcarbazepine and an oral contraceptive. Epilepsia 33: 1149–1152, 1992

    Article  Google Scholar 

  • Krämer G, Tettenborn B, Klosterskov Jensen P, Menge GP, Stoll KD. Oxcarbazepine does not affect the anticoagulant activity of warfarin. Epilepsia 33: 1145–1148, 1992

    Article  PubMed  Google Scholar 

  • Kristensen O, Klitgaard NA, Jönsson B, Sindrup S. Pharmacokinetics of 10-OH-carbazepine, the main metabolite of the antiepileptic oxcarbazepine, from serum and saliva concentrations. Acta Neurologica Scandinavica 68: 145–150, 1983

    Article  CAS  PubMed  Google Scholar 

  • Kumps A, Wurth C. Oxcarbazepine disposition: preliminary observations in patients. Biopharmaceutics and Drug Disposition 11: 365–370, 1990

    Article  CAS  PubMed  Google Scholar 

  • Leach MJ, Marden CM, Miller AA. Pharmacological studies on lamotrigine, a novel potential antiepileptic drug: II. Neurochemical studies on the mechanims of action. Epilepsia 27: 490–497, 1986

    CAS  Google Scholar 

  • Leppik IE, Dreifuss FE, Pledger GW, Graves NM, Santilli N, et al. Felbamate for partial seizures: results of a controlled clinical trial. Neurology 41: 1785–1789, 1991

    Article  CAS  PubMed  Google Scholar 

  • Leppik IE, Graves NM. Potential antiepileptic drugs: felbamate. In Levy et al. (Eds) Antiepileptic drugs, 3rd ed., pp. 983–990, Raven Press, New York, 1989

    Google Scholar 

  • Livingston JH, Beaumont D, Arzimanoglou A, Aicardi J. Vigabatrin in the treatment of epilepsy in children. British Journal of Clinical Pharmacology 27: 109–112, 1989

    Article  Google Scholar 

  • Loiseau P, Yuen AWC, Duché B, Ménager T, Arné-Bès MC. A randomized double-blind placebo-controlled cross-over add-on trial of lamotrigine in patients with treatment-resistant partial seizures. Epilepsy Research 7: 136–145, 1990

    Article  CAS  PubMed  Google Scholar 

  • Löscher W, Hönack D, Taylor CP. Gabapentin increases aminooxyacetic acid-induced GABA accumulation in several regions of rat brain. Neuroscience Letters 128: 150–154, 1991

    Article  PubMed  Google Scholar 

  • Luna D, Dulac O, Pajot N, Beaumont D. Vigabatrin in the treatment of childhood epilepsies: a single-blind placebo-controlled study. Epilepsia 30: 430–437, 1989

    Article  CAS  PubMed  Google Scholar 

  • Matilainen R, Pitkänen A, Ruutiainen T, Mervaala E, Sarlund H, et al. Effect of vigabatrin on epilepsy in mentally retarded patients: a 7-month follow-up study. Neurology 38: 743–747, 1988

    Article  CAS  PubMed  Google Scholar 

  • McGuire AM, Duncan JS, Trimble MR. Effects of vigabatrin on cognitive function and mood when used as add-on therapy in patients with intractable epilepsy. Epilepsia 33: 128–134, 1992

    Article  CAS  PubMed  Google Scholar 

  • Meldrum B, Horton R. Blockade of epileptic responses in the photosensitive baboon, Papio papio, by two irreversible inhibitors of GABA-transaminase, gamma-acetylenic GABA (4-amino-hex-5-ynoic acid) and gamma-vinyl GABA (4-amino-hex-5enoic acid). Psychopharmacology 59: 47–50, 1978

    Article  CAS  PubMed  Google Scholar 

  • Meldrum BS. GABAergic mechanisms in the pathogenesis and treatment of epilepsy. British Journal of Clinical Pharmacology 27: 3S–11S, 1989

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mervaala E, Kälviäinen R, Riekkinen P. Electrophysiological effects favor gamma-vinyl GABA versus carbamazepine monotherapy in newly diagnosed epileptic patients. Abstract. Epilepsia 32: 7, 1991

    Google Scholar 

  • Mervaala E, Partanen J, Nousiainen U, Sivenius J, Riekkinen P. Electrophysiologic effects of gamma-vinyl GABA and carbamazepine. Epilepsia 30: 189–193, 1989

    Article  CAS  PubMed  Google Scholar 

  • Michelucci R, Tassinari CA. Response to vigabatrin in relation to seizure type. British Journal of Clinical Pharmacology 27: 119–124, 1989

    Article  Google Scholar 

  • Mikati MA, Schachter SC, Schomer DL, Keally M, Osborne-Shafer P, et al. Long-term tolerability, pharmacokinetic and preliminary efficacy study of lamotrigine in patients with resistant partial seizures. Clinical Neuropharmacology 12: 312–321, 1989

    Article  CAS  PubMed  Google Scholar 

  • Miller AA, Wheatley PL, Sawyer DA, Roth B, Baxter MG. Pharmacological studies on lamotrigine, a novel potential antiepileptic drug: I. Anticonvulsant profile in mice and rats. Epilepsia 27: 483–489, 1986

    CAS  PubMed  Google Scholar 

  • Mogensen PH, Jórrgensen L, Boas J, Dam M, Vesterager A, et al. Effects of dextropropoxyphene on the steady-state kinetics of oxcarbazepine and its metabolites. Acta Neurologica Scandinavica 85: 14–17, 1992

    Article  CAS  PubMed  Google Scholar 

  • Mumford JP, Dam M. Meta-analysis of European placebo controlled studies of vigabatrin in drug resistant epilepsy. British Journal of Clinical Pharmacology 27: 101–107, 1989

    Article  Google Scholar 

  • Oiler L, Russi A, Oiler Daurella L. Lamotrigine in Lennox-Gastaut syndrome. Abstract. Epilepsia 32: 58, 1991

    Google Scholar 

  • Patsalos PN, Elyas AA, Zakrewska JM. Protein binding of oxcarbazepine and its primary metabolite, 10-hydroxycarbazepine, in patients with trigeminal neuralgia. European Journal of Clinical Pharmacology 39: 413–415, 1990

    Article  CAS  PubMed  Google Scholar 

  • Peck AW. Clinical pharmacology of lamotrigine. Epilepsia 32: 9–12, 1991

    Article  Google Scholar 

  • Pitkänen A, Matilainen R, Ruutiainen T, Lehtinen M, Riekkinen P. Effect of vigabatrin (gamma-vinyl GABA) on amino acid levels in CSF of epileptic patients. Journal of Neurology, Neurosurgery and Psychiatry 51: 1395–1400, 1988

    Article  PubMed  PubMed Central  Google Scholar 

  • Ramsay RE, Pellock JM, Garnett WR, Sanchez RM, Valakas AM, et al. Pharmacokinetic s and safety of lamotrigine (Lamictal) in patients with epilepsy. Epilepsy Research 10: 191–200, 1991a

    Article  CAS  PubMed  Google Scholar 

  • Ramsay RE, Wallace J, Shellenberger K, Arbor A. Efficacy and safety of gabapentin (‘Neurontin’) as add-on therapy in patients with uncontrolled partial seizures. Abstract. Neurology 41: 330, 1991b

    Article  Google Scholar 

  • Reinikainen KJ, Keränen T, Halonen T, Komulainen H, Riekkinen PJ. Comparison of oxcarbazepine and carbamazepine: a double-blind study. Epilepsy Research 1: 284–289, 1987

    Article  CAS  PubMed  Google Scholar 

  • Rey E, Pons G, Richard Mo, Vauzelle F, D’Athis PH, et al. Pharmacokinetics of the individual enantiomers of vigabatrin (gamma-vinyl-GABA) in epileptic children. British Journal of Clinical Pharmacology 30: 253–257, 1990

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Richens A. Pharmacokinetics of lamotrigine. International Clinical Practice Series, No. 2, pp. 21–27, 1992

    Google Scholar 

  • Rimmer EM, Richens A. Interaction between vigabatrin and phenytoin. British Journal of Clinical Pharmacology 27: 27–33, 1989

    Article  Google Scholar 

  • Ring HA, Trimble MR, Costa DC, George MS, Verhoeff P, et al. Effect of vigabtrin on striatal dopamine receptors: evidence in humans for interactions of GABA and dopamine systems. Journal of Neurology, Neurosurgery and Psychiatry 55: 758–761, 1992

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sachdeo RC, Murphy JV, Kamin M. Felbamate in juvenile myoclonus epilepsy. Abstract. Epilepsia 33: 118, 1992

    Google Scholar 

  • Sachdeo RC, Sachdeo SK. Tolerability of felbamate in newly diagnosed epileptics. Abstract. Neurology 43: 308, 1993

    Google Scholar 

  • Sander JWAS, Hart YM, Trimble MR, Shorvon SD. Vigabatrin and psychosis. Journal of Neurology, Neurosurgery and Psychiatry 54: 435–439, 1991

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sander JWAS, Patsalos PN, Oxley JR, Hamilton MJ, Yuen WC. A randomized double-blind placebo-controlled add-on trial of lamotrigine in patients with severe epilepsy. Epilepsy Research 6: 221–226, 1990b

    Article  CAS  PubMed  Google Scholar 

  • Sander JWAS, Trevisol-Bittencourt PC, Hart YM, Shorvon SD. Evaluation of vigabatrin as an add-on drug in the management of severe epilepsy. Journal of Neurology, Neurosurgery and Psychiatry 53: 1008–1010, 1990a

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Schechter PJ. Clinical pharmacology of vigabatrin. British Journal of Clinical Pharmacology 27: 19–22, 1989

    Article  Google Scholar 

  • Schechter PJ, Tranier Y, Jung MJ, Böhlen P. Audiogenic seizure protection by elevated brain GABA concentration in mice: effects of gamma-acetylenic GABA and gamma-vinyl GABA, two irreversible GABA-T inhibitors. European Journal of Pharmacology 45: 319–328, 1977

    Article  CAS  PubMed  Google Scholar 

  • Schlumberger E, Chavez F, Palacios L, Dulac O, Kouzan S, et al. Lamotrigine in the treatment of childhood epilepsies — a single-blind, placebo-controlled study. Abstract. Epilepsia 32: 58, 1991

    Google Scholar 

  • Shin C, Rigsbee LC, McNamara JO. Anti-seizure and anti-epileptogenic effect of gamma-vinyl-gamma-aminobutyric acid in amygdaloid kindling. Brain Research 398: 370–374, 1986

    Article  CAS  PubMed  Google Scholar 

  • Sillanpää M. Carbamazepine. In Wyllie (Ed.) The treatment of epilepsy: principles and practice, pp. 867–886, Lea & Febiger, Philadelphia, 1993

    Google Scholar 

  • Sillanpää M, Pihlaja T. Oxcarbazepine (GP 47 680) in the treatment of intractable seizures. Acta Paediatrica Hungarica 29: 359–361, 1988–1989

    PubMed  Google Scholar 

  • Sivenius J, Kälviäinen R, Ylinen A, Riekkinen P. Double-blind study of gabapentin in the treatment of partial seizures. Epilepsia 32: 539–542, 1991b

    Article  CAS  PubMed  Google Scholar 

  • Sivenius J, Paljärvi L, Vapalahti M, Nousiainen U, Riekkinen PJ. Vigabatrin (gamma-vinyl-GABA): neuropathological evaluation in five patients. Epilepsia 34: 193–196, 1993

    Article  CAS  PubMed  Google Scholar 

  • Sivenius MRJ, Ylinen A, Murros K, Matilainen R, Riekkinen P. Double-blind dose reduction study of vigabatrin in complex partial epilepsy. Epilepsia 28: 688–692, 1987

    Article  CAS  PubMed  Google Scholar 

  • Sivenius J, Ylinen A, Murros K, Mumford JP, Riekkinen PJ. Vigabatrin in drug-resistant partial epilepsy: a 5-year follow-up study. Neurology 41: 562–565, 1991a

    Article  CAS  PubMed  Google Scholar 

  • Smith D, Baker G, Davies G, Dewey M, Chadwick DW. Outcomes of add-on treatment with lamotrigine in partial epilepsy. Epilepsia 34: 312–322, 1993

    Article  CAS  PubMed  Google Scholar 

  • Smith DB, Mattson RH, Cramer JA, Collins JF, Novelly RA, et al. Veterans Administration Epilepsy Cooperative Study Group: results of a nationwide Veterans Administration Cooperative Study comparing the efficacy and toxicity of carbamazepine, phenobarbital, phenytoin and primidone. Epilepsia 28: S50–S58, 1987

    Article  PubMed  Google Scholar 

  • Steinhoff BJ, Stoll K-D, Stodieck SRG, Paulus W. Hyponatremic coma under oxcarbazepine therapy. Epilepsy Research 11: 67–70, 1992

    Article  CAS  PubMed  Google Scholar 

  • Tartara A, Manni R, Galimberti CA, Morini R, Mumford JP, et al. Six-year follow-up study on the efficacy and safety of vigabatrin in patients with epilepsy. Acta Neurologica Scandinavica 86: 247–251, 1992

    Article  CAS  PubMed  Google Scholar 

  • Theodore WH, Raubertas RF, Porter RJ, Nice F, Devinsky O, et al. Felbamate: a clinical trial for complex partial seizures. Epilepsia 32: 392–397, 1991

    Article  CAS  PubMed  Google Scholar 

  • UK Gabapentin Study Group. Gabapentin in partial epilepsy. Lancet 335: 1114–1117, 1990

    Article  Google Scholar 

  • Van Heiningen PNM, Eve MD, Oosterhuis B, Jonkman JHG, de Bruin H, et al. The influence of age on the pharmacokinetics of the antiepileptic agent oxcarbazepine. Clinical Pharmacology and Therapeutics 50: 410–419, 1992

    Article  Google Scholar 

  • Wallace SJ. Add-on trial of lamotrigine in resistant childhood seizures. Brain and Development 12: 734, 1990

    Google Scholar 

  • Ward DL, Wagner ML, Perhach JL, Kramer L, Graves N, et al. Felbamate steady-state pharmacokinetics during coadministration of valproate. Abstract. Epilepsia 32: 8, 1991

    Google Scholar 

  • Ward DL, Weliky I, Shumaker RC, Perhach JL. Dose proportionality of felbamate (felbatol) following oral administration of 200, 400, or 600 mg b.i.d. to healthy men. Abstract. Epilepsia 33: 83–84, 1992

    Google Scholar 

  • Warner T, Patsalos PN, Prevett M, Elyas AA, Duncan JS. Lamotrigine-induced carbamazepine toxicity: an interaction with carbamazepine-10,11-epoxide. Epilepsy Research 11: 147–150, 1992

    Article  CAS  PubMed  Google Scholar 

  • Wheatley PL, Miller AA. Effects of lamotrgine on electrically induced afterdischarge duration in anaesthetised rat, dog, and marmoset. Epilepsia 30: 34–40, 1989

    Article  CAS  PubMed  Google Scholar 

  • Wilensky AJ, Friel PN, Ojeman LM, Kupferberg HJ, Levy RH. Pharmacokinetics of W-554 (ADD 03055) in epileptic patients. Epilepsia 26: 602–606, 1985

    Article  CAS  PubMed  Google Scholar 

  • Wilensky AJ, Temkin NR, Ojeman LM, Riscker B, Holubkov A, et al. Gabapentin and carbamazepine as monotherapy and combined: a pilot study. Abstract. Epilepsia 33: 77, 1992

    Google Scholar 

  • Vollmer K-O, Anhut H, Thomann P, Wagner F, Jähnchen D. Pharmacokinetic model and absolute bioavailability of the new anticon-vulsant gabapentin. Advances in Epileptology 17: 209–211, 1989

    Google Scholar 

  • Vollmer K-O, Hodenberg AV, Kölle EU. Pharmacokinetics and metabolism of gabapentin in rat, dog and man. Arzneimittel-Forschung 36: 830–839, 1986

    CAS  PubMed  Google Scholar 

  • Ylinen AMA, Miettinen R, Pitkänen A, Gulyas AI, Freund T, et al. Enhanced GABAergic inhibition preserves hippocampal structure and function in a model of epilepsy. Proceedings of the National Academy of Sciences of the United States of America 88: 7650–7653, 1991

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ylinen A, Sivenius J, Pitkänen A, Halonen T, Partanen J, et al. Gamma-vinyl GABA (Vigabatrin) in epilepsy: clinical, neuro-chemical and neurophysiologic monitoring in epileptic patients. Epilepsia 33: 917–922, 1992

    Article  CAS  PubMed  Google Scholar 

  • Yuen AWC, Chapman A. Interim report on an open multicenter lamotrigine (‘Lamictal’) versus carbamazepine monotherapy trial in patients with epilepsy. Epilepsia 33: 82–83, 1992

    Google Scholar 

  • Yuen AWC, Rafter JEW. Lamotrigine (‘Lamictal’) as add-on therapy in pediatric patients with treatment-resistant epilepsy: an overview. Epilepsia 33: 82–83, 1992

    Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, University of Kuopio, POB 1627, 70211, Kuopio, Finland

    Reetta Kälviäinen & Paavo J. Riekkinen Sr

  2. Department of Neurology, University of Tampere, Tampere, Finland

    Tapani Keränen

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  1. Reetta Kälviäinen
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  2. Tapani Keränen
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  3. Paavo J. Riekkinen Sr
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Kälviäinen, R., Keränen, T. & Riekkinen, P.J. Place of Newer Antiepileptic Drugs in the Treatment of Epilepsy. Drugs 46, 1009–1024 (1993). https://doi.org/10.2165/00003495-199346060-00006

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