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Epilepsietherapie mit Antiepileptika der dritten Wahl

Felbamat, Tiagabin und Sultiam

Treatment of epilepsy with third-line antiepileptic drugs

Felbamate, tiagabine, and sulthiame

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Zusammenfassung

Hintergrund

Wir analysierten retrospektiv die Wirksamkeit der Komedikation mit Felbamat (FBM), Tiagabin (TGB) oder Sultiam (STM) bei Patienten mit fokalen Epilepsien.

Ergebnisse

Einundvierzig Patienten (25 Männer, 16 Frauen, mittleres Alter 29 Jahre, Erkrankungsdauer im Mittel 25 Jahre) erhielten FBM. Bei 9 Patienten (21,9%) wurde die Anfallsfrequenz mindestens halbiert (mittlere FBM Dosis 3211 mg), 13 Patienten (31,7%) berichteten Nebenwirkungen (NW). 53 Patienten (26 Männer, 27 Frauen, mittleres Alter 38 Jahre, Erkrankungsdauer im Mittel 24 Jahre) erhielten TGB. Bei 7 Patienten (13,2%) wurde die Anfallsfrequenz mindestens halbiert (mittlere TGB Dosis 32,9 mg), 28 Patienten (52,8%) berichteten NW. 28 Patienten (14 Männer, 14 Frauen, mittleres Alter 32,6 Jahre, Erkrankungsdauer im Mittel 24,9 Jahre) erhielten STM. Bei 5 Patienten (17,8%) wurde die Anfallsfrequenz mindestens halbiert (mittlere STM Dosis 275 mg), 4 Patienten (14,2%) berichteten NW.

Schlussfolgerung

Bei insgesamt guter Verträglichkeit bieten auch selten eingesetzte Antiepileptika wie FBM und STM eine realistische Chance zur Minderung der Anfallsfrequenz.

Abstract

Background

We retrospectively analysed the anticonvulsant efficacy of add-on treatment with felbamate (FBM), tiagabine (TGB), or sulthiame (STM) in patients with intractable focal and/or secondarily generalised seizures.

Results

Forty-one patients (25 men, 16 women, mean age 29 years, mean duration of epilepsy 25 years) were treated with FBM. In nine patients (21.9%) seizure frequency was reduced by more than 50% (mean FBM dosage 3211 mg), and 13 patients (31.7%) reported side effects. Fifty-three patients (26 men, 27 women, mean age 38 years, mean duration of epilepsy 24 years) were treated with TGB. In seven patients (13.2%) seizure frequency was reduced by more than 50% (mean TGB dosage 32.9 mg), and 28 patients (52.8%) reported side effects. Twenty-eight patients (14 men, 14 women, mean age 32.6 years, mean duration of epilepsy 24.9 years) were treated with STM. In five patients (17.8%) seizure frequency was reduced by more than 50% (mean STM dosage 275 mg), and four patients (14.2%) reported side effects.

Conclusion

Third-line antiepileptic drugs, especially FBM and STM, are fairly well tolerated and contribute to seizure control.

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Interessenskonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: Die Datenanalyse erfolgte ohne Sponsoring. Herr Professor Bauer erhielt in den letzten Jahren Vortragshonorare der Desitin Arzneimittel GmbH, Hamburg, dem Hersteller von Sultiam. Die Vorträge widmeten sich thematisch nicht dieser Substanz. Frau Chahem erhielt keine Firmenhonorare.

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Authors and Affiliations

  1. Klinik für Epileptologie, Universitätsklinikum Bonn, Sigmund-Freud-Straße 25, 53105, Bonn, Deutschland

    J. Chahem &  J. Bauer

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  1. J. Chahem
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  2. J. Bauer
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Correspondence to J. Bauer.

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Chahem, J., Bauer, J. Epilepsietherapie mit Antiepileptika der dritten Wahl. Nervenarzt 78, 1407–1412 (2007). https://doi.org/10.1007/s00115-007-2302-4

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  • DOI: https://doi.org/10.1007/s00115-007-2302-4

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