J Korean Ster Func Neurosurg.
2021 Sep;17(2):83-91. 10.52662/jksfn.2021.00115.
New antiepileptic drugs: usage, adverse effects, and interactions
- Affiliations
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- 1Department of Neurosurgery, Chung-Ang University Hospital, Seoul, Korea
- KMID: 2534577
- DOI: http://doi.org/10.52662/jksfn.2021.00115
Abstract
- Valproic acid, phenytoin, carbamazepine, primidone, and ethosuximide are older antiepileptic drugs that have long been in use. However, many new drugs have been developed, and many clinicians often find it difficult to select appropriate drugs. We reviewed the usage, adverse effects, and interactions of new antiepileptic drugs, referring to the 2018 guideline of the American Association of Neurology. Lamotrigine should be considered for monotherapy in patients with new-onset focal epilepsy. For new-onset generalized epilepsy, valproic acid is still the first-line treatment. Pregabalin and perampanel are effective as adjuvant therapy for refractory adult focal epilepsy. Lamotrigine and levetiracetam should be considered as adjuvant therapy for generalized refractory epilepsy. Lamotrigine and levetiracetam are relatively safe for use during pregnancy. Gabapentin, pregabalin, lamotrigine, topiramate, levetiracetam, zonisamide, lacosamide, perampanel, rufinamide, eslicarbazepine acetate, and clobazam all have different indications for usage and adverse effects. Treatment must be individualized by selecting appropriate drugs according to patients’ risk of complications.
