This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (23)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Neurology  • Epilepsy  • Alert me on articles by topic  Social Bookmarking   What's this?

Clinical Applications

Suzette M. LaRoche, MD; Sandra L. Helmers, MD

JAMA. 2004;291:615-620.

In the past decade, 8 new antiepileptic drugs have been approved for use in the United States, offering many new treatment options to patients with epilepsy. With expanding use of these newer agents, primary care clinicians are challenged with understanding the roles that each new agent plays in the treatment of patients with epilepsy as well as possible interactions with other pharmacological therapies. Each new medication provides a unique profile of pharmacokinetics, adverse effects, and mechanisms of action, making an appreciation of how these agents are best utilized even more difficult. Despite well-performed trials evaluating the safety and efficacy of specific antiepileptic drugs, the lack of head-to-head comparisons among them makes it difficult to endorse a single therapeutic regimen. Limited studies have compared the new antiepileptic drugs with more traditional medications and found similar efficacy but improved tolerability of the newer agents. There remains no well-established guidelines for choosing a particular antiepileptic drug or for choosing a newer agent over a traditional one. However, careful consideration of seizure type, patient comorbidities, and specific medication toxicities aids in prescribing the most appropriate medication. This article aims to familiarize the general practitioner with the appropriate roles and effective uses of the new antiepileptic drugs in specific clinical scenarios.

Author Affiliations: Department of Neurology, Emory University (Drs LaRoche and Helmers), and Atlanta VA Medical Center (Dr LaRoche), Atlanta, Ga.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

The New Antiepileptic Drugs: Scientific Review
Suzette M. LaRoche and Sandra L. Helmers
JAMA. 2004;291(5):605-614.
ABSTRACT | FULL TEXT  

Epilepsy
Sharon Parmet, Cassio Lynm, and Richard M. Glass
JAMA. 2004;291(5):654.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Antiepileptic drug use and rates of hip bone loss in older men: A prospective study
Ensrud et al.
Neurology 2008;71:723-730.
ABSTRACT | FULL TEXT  

Pharmacotherapy Overview of Seizure Management in the Adult Emergency Department
Idrees and Londner
Journal of Pharmacy Practice 2005;18:394-411.
ABSTRACT  

The Impact of New Drug Introduction on Drug Expenditure in Primary Health Care in Catalunya, Spain
Zara et al.
The Annals of Pharmacotherapy 2005;39:177-182.
ABSTRACT | FULL TEXT  

Reviews of Note
JWatch Psychiatry 2004;2004:10-10.
FULL TEXT