Epilepsy medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

overview

Medical Therapy

Pharmacologic medical therapies for epilepsy is anti-seizure drugs such as:

Drugs that affect voltage-dependent Na+ channels

Drugs that affect Ca currents

Drugs that affect GABA activity

Drugs that affect glutamate receptor

Drugs with multiple mechanisms of action

Drugs with other mechanisms of action

  • Brivaracetam
    • It can be used for treatment of focal-onset seizures and generalized epilepsy.[47][48]
    • The initial dosage is 50 mg twice daily.[49]
    • The most common side effects are irritability, anxiety, insomnia and depression.[50]
  • Gabapentin
    • It can be used for treatment of refractory focal seizures.[51]
    • The initial dosage is 300 mg three times daily.
    • The maximum dosage is 2400 mg/day.[52]
    • The most common side effects are sedation, dizziness, ataxia and weight gain.[53]
  • Levetiracetam
    • It can be used for adjunctive treatment of focal-onset seizures, myoclonic seizures in patients older than 12 y/o with juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures in patients older than six y/o with idiopathic generalized epilepsy.[54][55][56]
    • The initial dosage is 500 mg twice daily.
    • The maximum dosage is 4000 mg daily.[57]
    • The most common side effects are fatigue, drowsiness, dizziness, and upper respiratory tract infection.[58]
  • Pregabalin
    • It can be used for adjunctive therapy for focal seizures.[59]
    • The initial dosage is 150 mg daily in either two or three divided doses.[60]
    • The most common side effects are dizziness, gait abnormalities and drowsiness.[61]

References

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