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Published in: Drugs 1/2000

01-07-2000 | Review Article

Newer Anticonvulsants

Comparative Review of Drug Interactions and Adverse Effects

Authors: Dr Anne Sabers, Lennart Gram

Published in: Drugs | Issue 1/2000

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Abstract

The tolerability and drug interaction profiles of 6 new anticonvulsants: oxcarbazepine, vigabatrin, lamotrigine, gabapentin, tiagabine and topiramate, are reviewed. In general, these new anticonvulsants are well tolerated and drug interaction problems are minor with the exception of the risk of failure of oral contraceptives during treatment with oxcarbazepine or topiramate.
In this review, the clinical implications of the tolerability of these drugs are discussed for different patient groups. The choice of which new anticonvulsant for which patient depends upon individual factors, in particular, seizure type, tolerability and practical administration factors.
Treating elderly patients may be complicated by an increased sensitivity to adverse effects as these patients very often receive polytherapy for accompanying diseases. Drugs with very simple pharmacokinetic properties may be preferred in this group. Women of childbearing age face specific problems related to the epilepsy and to treatment with anticonvulsants. These include impaired fertility, failure of oral contraceptives and the risk of birth defects. Some new anticonvulsants may be suggested in preference to classical drugs to avoid these problems, but the human experience with newer anticonvulsants is still limited and, therefore, so is knowledge of the risk of congenital malformations in the offspring of mothers taking anticonvulsants. Psychiatric and behavioural changes frequently complicate treatment of patients with mental retardation. Some of the new anticonvulsants, in particular those affecting the γ-aminobutyric acid (GAB A) system such as vigabatrin, seem to exacerbate this problem and should be used with caution in these patients.
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Metadata
Title
Newer Anticonvulsants
Comparative Review of Drug Interactions and Adverse Effects
Authors
Dr Anne Sabers
Lennart Gram
Publication date
01-07-2000
Publisher
Springer International Publishing
Published in
Drugs / Issue 1/2000
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.2165/00003495-200060010-00003

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