LaRoche Suzette M
Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.
Neurologist. 2007 May;13(3):133-9. doi: 10.1097/01.nrl.0000256353.14257.7c.
To review data from the literature regarding the efficacy and tolerability of the second-generation antiepileptic drugs which were approved by the Food and Drug Administration (FDA) since 1994.
A MEDLINE search of the literature, as well as review of bibliographies, was performed to identify randomized controlled trials and other reports evaluating efficacy, pharmacokinetic profile, adverse effects, and drug interactions of the second-generation antiepileptic drugs. Key search terms included felbamate, gabapentin, lamotrigine, topiramate, tiagabine, levetiracetam, oxcarbazepine, zonisamide, and pregabalin.
Each of the second-generation antiepileptic drugs has demonstrated statistically significant reductions in seizure frequency over baseline compared with placebo or active control. Limited studies of efficacy of the new agents compared with the traditional antiepileptic drugs found no significant differences. Each of the second-generation antiepileptic drugs has a unique pharmacokinetic and side-effect profile. Compared with the traditional agents, the second-generation antiepileptic drugs have fewer serious adverse effects, as well as drug interactions.
Knowledge of the second-generation antiepileptic drugs has greatly expanded over the past decade. The newer agents offer many options in the treatment of epilepsy that are safe, efficacious, and well tolerated.
回顾自1994年以来美国食品药品监督管理局（FDA）批准的第二代抗癫痫药物的疗效和耐受性相关的文献数据。
对MEDLINE数据库进行文献检索，并查阅参考文献，以识别评估第二代抗癫痫药物疗效、药代动力学特征、不良反应和药物相互作用的随机对照试验及其他报告。关键检索词包括非氨酯、加巴喷丁、拉莫三嗪、托吡酯、噻加宾、左乙拉西坦、奥卡西平、唑尼沙胺和普瑞巴林。
与安慰剂或活性对照相比，每种第二代抗癫痫药物均显示癫痫发作频率较基线有统计学显著降低。与传统抗癫痫药物相比，新药物疗效的有限研究未发现显著差异。每种第二代抗癫痫药物都有独特的药代动力学和副作用特征。与传统药物相比，第二代抗癫痫药物严重不良反应及药物相互作用较少。
在过去十年中，对第二代抗癫痫药物的认识有了很大扩展。这些新型药物为癫痫治疗提供了许多安全、有效且耐受性良好的选择。
