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Topic: Antiepileptic

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	NYU - Antiepileptic Drug Therapy (Site not responding. Last check: 2007-11-05)
		Although antiepileptic drugs work well for most persons in low to moderate doses, some persons do not tolerate the medications, or their seizures cannot be controlled even with high doses of one or more drugs.
		Antiepileptic drugs vary considerably in how they work, how long they remain in the blood (half-life), and how they should be taken.
		Antiepileptic drugs are expensive, but there are several ways to cut their costs.
	www.neurologychannel.com /nyu/antiepileptic.html (7058 words)

	Causes and Treatments of Seizures
		Antiepileptic drugs act by: (1) preventing the sodium channel from opening; (2) facilitating the passage of chloride ions into the cell; (3) inhibiting T-calcium currents; and (4) antagonizing one or more types of glutamate receptors.
		The following factors should be considered prior to the initiation of antiepileptic drugs in neonates with seizures without etiology-specific therapy: (1) clinical consequences, and duration and frequency of the seizure; (2) natural history of the disorder; and (3) possible side effects of the seizures and the antiepileptic drugs.
		Most physicians tend to use antiepileptic drugs for prolonged and recurrent focal and clonic paroxysmal motor events, and avoid using antiepileptic drugs for myoclonus provoked by stimulation or for generalized tonic posturing or automatisms provoked by stimulation or suppressed by restraint.
	pediatricneuro.com /alfonso/pg58.htm (352 words)

	Discontinuing Antiepileptic Drugs (Site not responding. Last check: 2007-11-05)
		Antiepileptic drugs may not have to be taken for a lifetime.
		Abrupt cessation of antiepileptic drugs is always risky and may precipitate not only a return of seizures, but even a bout of prolonged or status seizures.
		The decision on whether to try a phased withdrawal from antiepileptic drugs is more difficult for adults than for children, especially when the adult drives or has a job in which an unexpected seizure would have severe social and career implications.
	www.epilepsyfoundation.org /answerplace/Medical/treatment/medications/discontinuing.cfm (389 words)

	Children's Epilepsy Program : Antiepileptic Medications
		Antiepileptic medication is usually prescribed for children with recurrent seizures, ideally after a specific epilepsy syndrome diagnosis is made and the risk of subsequent seizures is known.
		An antiepileptic medication is swallowed by mouth and passes directly to the stomach.
		Antiepileptic medications are classified into categories from low risk of causing harm to a foetus through to high risk of harm occurring.
	www.rch.org.au /cep/treatments/index.cfm?doc_id=3242 (2057 words)

	eMedicine - Antiepileptic Drugs: An Overview : Article by Juan G Ochoa, MD
		It was discovered by accident; first synthesized in 1882, its antiepileptic properties were recognized when it was used as a solvent for the experimental screening of new antiepileptic compounds.
		It exerts an inhibitory effect on sodium conductance, decreasing the duration of spontaneous bursts and the frequency of generated action potentials, enhances GABA by unknown mechanisms, inhibits the AMPA subtype glutamate receptor, and is a weak inhibitor of carbonic anhydrase.
		Antiepileptic drugs can be grouped according to their major mechanism of action.
	www.emedicine.com /neuro/topic692.htm (12343 words)

	American Family Physician: Antidepressants and antiepileptic drugs for chronic non-cancer pain
		Neuropathic pain typically is treated with medications that influence neurotransmitters (e.g., antidepressants, antiepileptic drugs), and treatment with opioids is reserved for patients with refractory neuropathic pain.
		Mechanism of Action of Antidepressants and Antiepileptic Drugs in Pain Syndromes Transmission of painful stimuli through the spinal column and CNS is modulated by excitatory and inhibitory neurotransmitters, as well as actions at sodium and calcium channels.
		Antiepileptic drugs act at several sites that may be relevant to pain, but the precise mechanism of their analgesic effect remains unclear.
	www.findarticles.com /p/articles/mi_m3225/is_3_71/ai_n11836585 (1312 words)

	DMR Medical Advisory 98-6
		It is possible that short-term increases in established antiepileptic drug doses or the administration of a short-acting agent will abort such activity, but the institution of such a treatment program should be made carefully after the natural history and response to medication are well understood.
		Antiepileptic drug levels can subsequently be measured to test for major changes in pharmacokinetics caused by drug interaction.
		Antiepileptic drug blood levels are obtained to determine if the oral dose is adequate or to explain the cause of toxic symptoms, especially if polytherapy if used.
	www.dmr.state.ct.us /publications/centralofc/hcs_ma98-6.htm (2669 words)

	Side Effects of Newer Antiepileptic Drugs
		Three antiepileptic drugs—levetiracetam, topiramate, and zonisamide—were significantly associated with psychiatric side effects, and two drugs —lamotrigine and the older agent carbamazepine—demonstrated a trend toward a lower risk.
		Conversely, some antiepileptic drugs are unlikely to cause certain side effects, Dr. Hirsch noted, citing the low incidence of psychiatric side effects associated with lamotrigine, gabapentin, and oxcarbazepine.
		Because the newer antiepileptic drugs are in general better tolerated than established agents such as carbamazepine, phenobarbital, phenytoin, and valproic acid, knowing which newer drug is associated with which set of side effects has taken on a greater significance for clinicians and patients.
	www.neurologyreviews.com /jun04/nr_jun04_AEDside.html (1150 words)

	New antiepileptic drugs (Site not responding. Last check: 2007-11-05)
		However, the established antiepileptic drugs have potential adverse effects and are known to be teratogenic, and not all patients respond to treatment.
		The new antiepileptic drugs are currently used as add-on therapy for the management of patients with seizure disorders.
		Given the overlap in clinical indications, choice of one of the newer antiepileptic drugs is often based on known adverse effects, interactions (see box) and familiarity with using a particular drug.
	www.australianprescriber.com /magazines/vol22no3/antiepileptic.htm (1515 words)

	Seizure induced by antiepileptic drugs
		Positive evidence indicates that antiepileptic drugs may worsen a pre-existing seizure by increasing its frequency or inducing a new type of seizure.
		Reaching a conclusion that a particular antiepileptic drug has the potential to worsen certain types of seizures may be determined by several factors.
		The other important factor to be excluded before naming an antiepileptic drug as a pro-epileptic agent is if this event of aggravation was only a coincidence and not related to inappropriate control of the seizure.
	www.kfshrc.edu.sa /annals/203_204/99-161R.htm (1444 words)

	The Antiepileptic Drug Pregnancy Registry at Mass General Hospital in Boston Massachusetts
		The Antiepileptic Drug Pregnancy Registry at Mass General Hospital in Boston Massachusetts
		The primary goal is to determine the frequency of major malformations, such as heart defects, spina bifida and cleft lip, in the infants exposed during pregnancy to anticonvulsant drugs.
		Any woman who is currently pregnant and is taking AEDs (antiepileptic drugs) for any reason can enroll in the Registry.
	www.mgh.harvard.edu /aed (169 words)

	Guidelines Clarify Role of New Antiepileptic Drugs
		With respect to choosing between the new or old antiepileptic drugs for refractory epilepsy, the panel determined that there was no Class I evidence, leaving antiepileptic drug selection to clinical determinants such as pharmacology, side-effect profile, and risk of toxicity.
		However, the clinical experience for new antiepileptic drugs is far more limited than for the old antiepileptic drugs, the investigators noted, and evidence for teratogenicity as well as the incidence of idiosyncratic reactions and other adverse effects may reflect this shorter duration of clinical observation.
		Patients in whom old antiepileptic drugs are interfering or may interfere with the efficacy or safety of concomitant medications.
	www.neurologyreviews.com /jul04/nr_jul04_epilepsy.html (1574 words)

	Antiepileptic Pill: Chinese Herbal Medicine
		It is a brain disorder in which clusters of nerve cells, or neurons, in the brain sometimes signal abnormally.
		For others it may be necessary to take antiepileptic drugs for a period of years, even if seizures have stopped, as the underlying cause of the seizures may still be there.
		Antiepileptic Pill comprises 3 to 5 Chinese herbal medicine which can fortify brain and increase wisdom, brighten the eyesight and increase auditory sensation, supplement Qi and quicken blood, nourish liver and kidney, stop spasm and wind, sweep phlegm and dissipate dampness, improve blood circulation in brain and increase blood circulation volume,
	www.damo-qigong.net /treat/epilepsy (1190 words)

	New Oral Antiepileptic Agents
		The doses of oral antiepileptic agents are increased until a patient becomes seizure-free or experiences intolerable side effects.
		Routine therapeutic drug monitoring, as seen with the traditional antiepileptic agents (See Table 2), cannot be recommended for the newer agents due to lack of data for target concentration ranges.
		Despite these six agents, it is estimated that 25 to 40% of patients with epilepsy continued to have seizures despite optimal treatment with traditional antiepileptic drugs.
	www.clevelandclinicmeded.com /medical_info/pharmacy/Novdec2001/antiepileptic.htm (2689 words)

	Antiepileptic Drugs : Epilepsy.com
		In particular, it is known that the body’s ability to break down some antiepileptic drugs, particularly lamotrigine, increases during pregnancy: this leads to a fall in the blood level of the drug, and reduced protection against seizures.
		In this study, the clinical anticonvulsive effects and the onset of action of a new antiepileptic drug “Levetiracetam” as two days after drug initiation were confirmed by using TISA method and these results were comparable to that found in studies involving more patients and lasting longer period.
		Pregabalin is an antiepileptic medication introduced in many countries in 2004-2005 for the treatment of partial epilepsy in adults, when administered in combination with other antiepileptic drugs (AEDs).
	www.epilepsy.com /epilepsy/antiepileptic_drugs.html (11379 words)

	News - Antiepileptic Use Linked To Reduced Ocular Perfusion
		Patients who take antiepileptic drugs have reduced blood flow in their ocular area, which may have an impact on their visual functioning.
		Among 14 patients taking antiepileptic drugs for the treatment of epilepsy, the investigators measured retinal capillary microvascular flow, volume and velocity in the temporal neuroretinal rim.
		The authors concluded that patients with epilepsy taking antiepileptic drugs have reduced neuroretinal capillary blood flow, volume and velocity compared with individuals without epilepsy who are not taking these agents.
	docguide.com /news/content.nsf/news/8525697700573E1885256C6D00214383 (388 words)

	Epilepsy Fdn.-Video News Release: New Data Released on Pre-Pregnancy Use of Anti-Seizure Drugs
		The convergence of statistically-significant data from antiepileptic drug pregnancy registries from around the world is beginning to provide clear guidance to women and their physicians about the use of antiepileptic drugs during pregnancy and the risk of birth defects to the woman's child.
		Some antiepileptic drugs are associated with greatly-increased birth defect risk, while others show promise of much lower risk.
		Antiepileptic drug use is growing, as they are increasingly used for treatment of several non-epileptic neurological pain symptoms such as migraines and tremor, and for psychiatric disorders such as mood and bipolar disorders.
	www.epilepsyfoundation.org /aboutus/pressroom/vnr20021207.cfm (266 words)

	Antiepileptic drug developed at Hebrew University to undergo phase three clinical trials
		Epilepsy is caused, among other reasons, by disturbances in the balance between these two functions: a rise in the level of the activating (excitatory) amino acids or a reduction in the level of the inhibitory acids.
		Glycine is one of the inhibitory acids, and increasing its concentration in the brain has an antiepileptic effect.
		The new drug, valrocemide, is a combination of a known antiepileptic drug, valproic acid, and a glycine derivative, glycinamide.
	www.eurekalert.org /pub_releases/2003-10/huoj-add100103.php (423 words)

	Antiepileptic Medications
		(Antiepileptic drugs are also commonly categorised as anticonvulsant drugs, however not all epileptic seizures induce convulsions in patients, and not seizures are caused by epilepsy.) The antiepileptic (seizure-preventing) drug will not work properly until reaches a certain level in the body (blood concentration) and that level has been maintained.
		Antiepileptic drug-level testing helps a physician achieve seizure control by monitoring the presence of a medication in a patient's bloodstream.
		Some antiepileptic medications may also reduce the effectiveness of oral contraceptives by increasing their metabolism by the liver and elimination by the body.
	www.epilepsy.ca /eng/content/antiepi.html (2217 words)

	NGC - NGC Summary
		Efficacy and tolerability of the new antiepileptic drugs II: treatment of refractory epilepsy: report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society.
		Efficacy and tolerability of the new antiepileptic drugs II: treatment of refractory epilepsy: report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the AES.
		Efficacy and tolerability of the new antiepileptic drugs for treatment of refractory epilepsy: AAN guideline summary for patients and their families.
	www.guideline.gov /summary/summary.aspx?ss=15&doc_id=5183&nbr=3565 (2817 words)

	Antiepileptic Drug Treatment of Nonconvulsive Seizures Induced by Experimental Focal Brain Ischemia -- Williams et al. ...
		Antiepileptic Drug Treatment of Nonconvulsive Seizures Induced by Experimental Focal Brain Ischemia -- Williams et al.
		Effect of antiepileptic drug treatment to reduce the incidence of NCS after permanent MCAo and 24-h recovery.
		Leite JP and Cavalheiro EA (1995) Effects of conventional antiepileptic drugs in a model of spontaneous recurrent seizures in rats.
	jpet.aspetjournals.org /cgi/content/full/311/1/220 (4624 words)

	News - Antiepileptic Drug, Keppra (Levetiracetam), Benefits Patients With Chronic Migraine: Presented at AAN
		Antiepileptic Drug, Keppra (Levetiracetam), Benefits Patients With Chronic Migraine: Presented at AAN
		SAN FRANCISCO, CA -- April 28, 2004 -- The antiepileptic drug levetiracetam (Keppra®) significantly reduced the frequency and impact of headaches in patients diagnosed with transformed migraine, according to a new study presented today at the 56
		All the participants had previously failed on one, but not more than three preventive drugs, and had taken no more than one antiepileptic drug.
	www.docguide.com /news/content.nsf/news/8525697700573E1885256E8400488EC8 (787 words)

	Hypnotic and antiepileptic effects of cannabidiol (Journal of Clinical Pharmacology, 1981; 21: 417S-427S) (Site not responding. Last check: 2007-11-05)
		Three other placebo patients (1, 4, and 5) remained under treatment for 12, 12, and eight weeks, respectively, after which they were withdrawn from the experiment and underwent a change in the prescribed antiepileptic drugs in an attempt to improve their condition.
		A note is in order about the method used to measure hypnotic effect of cannabidiol The use of self-reported questionnaires to evaluate hypnotic effects is considered a subjective method, in opposition to the objective methods such as the inspection of the volunteers in inpatient-settings throughout the night or the obtention of continuous EEG recordings.
		The clinical trial of cannabidiol as an eventual antiepileptic agent was conducted with eight cases of severely ill patients, refractory to all known antiepileptic drugs.
	www.thecompassionclub.org /library/epilepsy2.html (4117 words)

	British Journal of Pharmacology - Abstract of article: Gabapentin potentiation of the antiepileptic efficacy of ...
		On the basis of these mechanisms of action, a pharmacodynamic interaction of the two antiepileptic drugs could be supposed which might be of relevance in the sense of a rational polypharmacy.
		Both, the antiepileptic effect of vigabatrin alone and the enhancement by gabapentin were blocked by the GABA
		These results demonstrate that gabapentin is able to augment the antiepileptic effects of vigabatrin significantly.
	www.nature.com /bjp/journal/v124/n2/abs/0701825a.html (342 words)

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