Third-Generation Antiepileptic Drugs for Treating Partial-Onset Seizures

REVIEW ARTICLE


Gregory L Krauss, Joyce Choi and Tung Tran

Affiliation: Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA

ABSTRACT

Several new “third-generation” antiepileptic drugs (AEDs)—lacosamide, eslicarbazepine acetate, and retigabine—have been developed that may benefit patients with drug-resistant partial-onset seizures. We review the efficacy, tolerability, safety, and pharmacology of these new AEDs and compare these with previous AEDs used to treat partial-onset epilepsy. At optimal doses, the new AEDs benefit approximately 40% of patients with drug-resistant epilepsy, with few major safety concerns. Tolerability for the AEDs varied markedly across their dose ranges, with dizziness and other central nervous system (CNS)-related adverse events occurring relatively often at high doses when given in polytherapy. Studies are needed to directly compare the effectiveness of the three new and previous AEDs, and to determine the tolerability of new AEDs in patients whose concomitant AEDs are reduced. These “third-generation” AEDs provide potential new treatment options for patients failing treatment with previous AEDs.

Keywords: antiepilepsy drugs, anticonvulsants, epilepsy, eslicarbazepine, retigabine, lacosamide
Correspondence: Gregory L Krauss, Meyer 2-147, 600 N Wolfe St., Baltimore, MD 21287, USA. Tel: (1)-410-955-2822; Fax: (1)-410-955-0751;e-mail: gkrauss@Djhmi.edu