ADVANTAGES OF BROAD SPECTRUM ANTIEPILEPTIC DRUGS IN TREATMENT OF EPILEPSY
Abstract
Pharmacotherapy of epilepsy requires deep knowledge of anti-epileptic drugs (AEDs), including the following issues: spectrum of therapeutic efficacy and therapeutic strength, adverse effects (especially severe and life-threatening adverse reactions); specific features of pharmacokinetics, pharmacodynamics, and drug interactions; titration rate, the need for laboratory tests during treatment, pharmacoeconomic components. The main properties of antiepileptic drugs are defined by their mechanisms of action. Today, particular attention is paid to the drugs with broad spectrum activity, which give an ability to use them in patients with so-called undifferentiated epilepsies. In this article, the authors describe their own experience in optimization of antiepileptic therapy in a group of 141 patients with various forms of epilepsy. This new optimized strategy implies inclusion of modern broad spectrum AEDs in treatment schemes along with the reduction in use of narrow spectrum drugs. Moreover, polytherapy was used in most of the cases after treatment regimen correction. All the measures allowed to achieve remission in about half of the patients with epilepsy earlier considered as incurable.
About the Authors
K. V. Voronkova
N. I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
Voronkova Kira Vladimirovna – MD, PhD, professor at Department of Neurology.
1 Ostrovityanova St., Moscow, 117997
G. S. Golosnaya
City Clinical Hospital No 13
Russian Federation
Russian Federation
Golosnaya Galina Stanislavovna – MD, PhD, associate professor, neurologist at neonatal intensive care unit of CClH No 13 (Department of Obstetrics No 1).
3 Sharikopodshipnikovskaya St., Moscow, 115280
I. D. Lemeshko
I. M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
Lemeshko Irirna Dmitrievna – MD, doctor of functional diagnostics, neurologist, epileptologist at University Children’s Hospital of I. M. Sechenov First MSMU.
19/1 Bolshaya Pirogovskaya St., Moscow, 119435
A. S. Petrukhin
N. I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
Petrukhin Andrey Sergeevich – MD, PhD, professor at Department of Neurology, Neurosurgery and Medical Genetics of N. I. Pirogov RNRMU.
Ostrovityanova St., Moscow, 117997
References
1. Karlov V. A. Epilepsy in children and adult women and men: a manual for physicians [Epilepsiya u detei i vzroslykh zhenshchin i muzhchin: rukovodstvo dlya vrachei (in Russian)]. Moscow. 2010; 718 p.
2. Brodie M. Do we need any more new antiepileptic drugs? Epilepsy Res. 2001; 45: 3-6.
3. Kwan P., Brodie M. J. Early identification of refractory epilepsy. N. Engl. J. Med. 2000; 341: 314-9.
4. Panayiotopoulos C. P. A Clinical Guide to Epileptic Syndromes and their Treatment. Springer. 2010; 654 P.
5. Mikhailov V. A. Topical issues of epileptology: stigma, quality of life and rehabilitation of patients. Epilepsiya i paroksizmal’nye sostoyaniya / Epilepsy and paroxysmal conditions. 2010; 2 (3): 39-44.
6. Kwan P., Brodie M. J. Effectiveness of first antiepileptic drug. Epilepsia. 2001; 42: 1255-60.
7. Sazgar M., Bourgeois B. F. Aggravation of epilepsy by antiepileptic drugs. Pediatr Neurol. 2005; 33 (4): 227-34.
8. Perucca E. et al. Antiepileptic drugs as a cause of worsening seizures. Epilepsia. 1998; 39 (1): 5-17.
9. Genton P. When antiepileptic drugs aggravate epilepsy. Brain Dev. 2000; 22 (2): 75-80.
10. Arzimanoglou A. Treatment options in pediatric epilepsy syndromes. Epileptic disorders. 2002; 3: 217-225.
11. Benbadis S. R. The management of idiopathic generalized epilepsies. Acta Neurologica Scandinavica. 2005; 112: 63-67.
12. Vaz-Carneiro A. et al. Clinical comparability of the new antiepileptic drugs in refractory partial epilepsy: a systematic review and meta-analysis. Epilepsia. 2011; 52 (7): 1528-1167.
13. Voronkova K. V., Petrukhin A. S., Pylaeva O. A., Kholin A. S. Rational antiepileptic pharmacology. A guide for physicians [Ratsional’naya antiepilepticheskaya farmakologiya. Rukovodstvo dlya vrachei in Russian)]. Moscow. 2008; 192 p.
14. Brodie M. J., Johnson F. N. Carbamazepine in the treatment of seizure disorders: efficacy, pharmacokinetics and adverse event profile. Rev. Contemp. Pharmacother. 1997; 8: 87-122.
15. Kramer G. et al. Experience of generic drugs use in patients with epilepsy: electronic interview with the members of the German, Austrian and Swiss branches of the International League against epilepsy [Opyt primeneniya dzhenericheskikh preparatov u patsientov s epilepsiei: elektronnoe interv’yu chlenov nemetskogo, avstriiskogo i shveitsarskogo otdelenii Mezhdunarodnoi ligi po bor’be s epilepsiei. Epilepsia (in Russian)]. 2007; 48 (3): 609-611.
For citation:
Voronkova K.V., Golosnaya G.S., Lemeshko I.D., Petrukhin A.S. ADVANTAGES OF BROAD SPECTRUM ANTIEPILEPTIC DRUGS IN TREATMENT OF EPILEPSY. Epilepsy and paroxysmal conditions. 2017;9(1):79-85. (In Russ.) https://doi.org/10.17749/2077-8333.2017.9.1.079-085
Views: 1356
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Email this article 
