PMID- 25083209
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140801
LR  - 20211021
IS  - 2042-0986 (Print)
IS  - 2042-0994 (Electronic)
IS  - 2042-0986 (Linking)
VI  - 2
IP  - 4
DP  - 2011 Aug
TI  - New generation antiepileptic drugs: what do they offer in terms of improved 
      tolerability and safety?
PG  - 141-58
LID - 10.1177/2042098611411127 [doi]
AB  - Over the last two decades a total of 11 antiepileptic drugs (AEDs) have been 
      introduced to the US market. Randomized, placebo-controlled trials have yielded 
      information about each drug's efficacy, tolerability, and safety profile; 
      however, few studies have compared the newer generation AEDs directly with the 
      older generation. Comparative studies are not always straightforward in their 
      interpretation, as many characteristics of drugs, both favorable and unfavorable, 
      may not be highlighted by such studies. In general, findings from the literature 
      suggest that the newer generation AEDs (including vigabatrin, felbamate, 
      gabapentin, lamotrigine, tiagabine, topiramate, levetiracetam, oxcarbazepine, 
      zonisamide, pregabalin, rufinamide, and lacosamide) enjoy both improved 
      tolerability and safety compared with older agents such as phenobarbital, 
      phenytoin, carbamazepine, and valproate. This is partially supported by some of 
      the findings of the QSS and the TTA Committee of the American Academy of 
      Neurology (AAN), whose review of four AEDs (gabapentin, lamotrigine, topiramate, 
      and tiagabine) is discussed. Briefly, when compared with carbamazepine, 
      lamotrigine was better tolerated; topiramate adverse events (AEs) were fairly 
      comparable to carbamazepine and valproate; and tiagabine compared with placebo 
      was associated with a higher discontinuation rate due to AEs. The findings of the 
      SANAD trial are also presented; when administered to patients with partial 
      epilepsy, carbamazepine was most likely to fail due to AEs, and lamotrigine and 
      gabapentin were least likely to fail due to AEs. When administered to patients 
      with idiopathic generalized epilepsy, topiramate was most frequently associated 
      with AE-related discontinuation, followed by valproate; and while valproate was 
      the most efficacious drug in this arm of the study, lamotrigine was more 
      tolerable. What makes the SANAD study valuable and somewhat unique is its 
      head-to-head comparison of one drug with another. Such comparative trials are 
      overall lacking for new AEDs, although some conclusions can be drawn from the 
      available data. In the end, however, AED selection must be based on individual 
      patient and drug characteristics.
FAU - French, Jacqueline A
AU  - French JA
AD  - New York University School of Medicine, NYU Comprehensive Epilepsy Center, 223 
      East 34th Street, New York, NY 10016, USA.
FAU - Gazzola, Deana M
AU  - Gazzola DM
AD  - New York University School of Medicine, NYU Comprehensive Epilepsy Center, New 
      York, NY, USA.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Ther Adv Drug Saf
JT  - Therapeutic advances in drug safety
JID - 101549074
PMC - PMC4110862
OTO - NOTNLM
OT  - SANAD
OT  - adverse event
OT  - antiepileptic drug
OT  - safety
OT  - tolerability
OT  - toxicity
EDAT- 2011/08/01 00:00
MHDA- 2011/08/01 00:01
PMCR- 2011/08/01
CRDT- 2014/08/02 06:00
PHST- 2014/08/02 06:00 [entrez]
PHST- 2011/08/01 00:00 [pubmed]
PHST- 2011/08/01 00:01 [medline]
PHST- 2011/08/01 00:00 [pmc-release]
AID - 10.1177_2042098611411127 [pii]
AID - 10.1177/2042098611411127 [doi]
PST - ppublish
SO  - Ther Adv Drug Saf. 2011 Aug;2(4):141-58. doi: 10.1177/2042098611411127.