Contemporary pharmacotherapy of epilepsy

Authors: Iva Marečková;  Zdeněk Vojtěch;  Tomáš Procházka
Authors‘ workplace: Neurologické oddělení Nemocnice Na Homolce, Praha
Published in: Čas. Lék. čes. 2011; 150: 278-282
Category: Review Article


The epilepsies are a frequent group of neurologic disorders. We have witnessed significant advances in their medical treatment recently. About 70 % of newly diagnosed patients are rendered seizure-free. Antiepileptic drug treatment has become more complex. The choice of antiepileptic drug is based on seizure type. However, special patient’s needs (drug tolerability, toxicity, ease of use and cost and age, sex and commorbidities) should be considered. The article deals with these special situations. In case of seizure persistence epilepsy surgery could be an option.

Key words:
epilepsy, antiepileptic drug, epilepsy surgery.


1. Brázdil M, Hadač J, Marusič P (eds.). Farmakorezistentní epilepsie. Triton: Praha 2004; 272.

2. EpiStop. Soubor minimálních diagnostických a terapeutických standardů u pacientů s epilepsií. Maxdorf: Praha 2007.

3. Seneviratne U. Management of the first seizure: an evidence based approach. Postgrad Med J 2009; 85: 667–673.

4. Marson AG, et al. SANAD Study group. The SANAD study of effectiveness of valproate, lamotrigine, or topiramate for generalised and unclassifiable epilepsy: an unblinded randomised controlled trial. Lancet 2007; 369: 1016–1026.

5. Marson AG, et al. SANAD Study group. The SANAD study of effectiveness of carbamazepine, gabapentin, lamotrigine, oxcarbazepine, or topiramate for treatment of partial epilepsy: an unblinded randomised controlled trial. Lancet 2007; 369: 1000–1015.

6. Schmidt D. Strategies to prevent overtreatment with antiepileptic drugs in patients with epilepsy. Epilepsy Res 2002; 52: 61–69.

7. Hovorka J, Nežádal T. Kombinovaná léčba antiepileptiky u epilepsie: taktika, volba léků, interakce. Neurol pro praxi 2007; 2: 80–85.

8. Asconapé JJ. The selection of antiepileptic drugs for the treatment of epilepsy in children and adults. Neurol Clin 2010; 28: 843–852.

9. French JA, Faught E. Rational polytherapy. Epilepsia 2009; 50 (Suppl 8): 63–68.

10. Rektor I. Farmakoterapie epilepsie: limity a skalí Neurol pro praxi 2007; 2: 68.

11. Brodie MJ. Medical therapy of epilepsy: when to initiate treatment and when to combine? J Neurol 2005; 252: 125–130.

12. Mintzer S. Metabolic consequences of antiepileptic drugs. Curr Opin Neurol 2010; 23: 164–169.

13. Arif H, Buchsbaum R, Pierro J, et al. Comparative effectiveness of 10 antiepileptic drugs in older adults with epilepsy. Arch Neurol 2010; 67: 408–415.

14. Chaves J, Sander JW. Seizure aggravation in idiopathic generalized epilepsies. Epilepsia 2005; 46 Suppl 9: 133–139.

15. Schmidt D, Baumgartner C, Löscher W. Seizure recurrence after planned discontinuation of antiepileptic drugs in seizure-free patients after epilepsy surgery: a review of current clinical experience. Epilepsia 2004; 45: 179–186.

16. Sillanpää M, Schmidt D. Prognosis of seizure recurrence after stopping antiepileptic drugs in seizure-free patients: A long-term population-based study of childhood-onset epilepsy. Epilepsy Behav 2006; 8: 713–719.

17. Schmidt D, Löscher W. Uncontrolled epilepsy following discontinuation of antiepileptic drugs in seizure–free patients: a review of current clinical experience. Acta Neurol Scand 2005; 111: 291–300.

18. Kim YD, Heo K, Park SC, et al. Antiepileptic drug withdrawal after successful surgery for intractable temporal lobe epilepsy. Epilepsia 2005; 46: 251–257.

19. Kwan P, Sperling MR. Refractory seizures: try additional antiepileptic drugs (after two have failed) or go directly to early surgery evaluation? Epilepsia 2009; 50(Suppl 8): 57–62.

Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management

Article was published in

Journal of Czech Physicians

Issue 4-5

2011 Issue 4-5

Most read in this issue
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account