Hwang Hee, Kim Ki Joong
Department of Pediatrics, Seoul National University Childern's Hospital, 28 Yongon-dong, Jongno-gu, Seoul 110-744, South Korea.
Brain Dev. 2008 Oct;30(9):549-55. doi: 10.1016/j.braindev.2008.01.007. Epub 2008 Mar 6.
New antiepileptic drugs (AEDs), introduced since 1993, provide more diverse options in the treatment of epilepsy. Despite the equivalent efficacy and better tolerability of these drugs, more than 25% of patients remain refractory to treatment. Moreover, the issues for pediatric patients are different from those for adults, and have not been addressed in the development and application of the new AEDs. Recently published evidence-based treatment guidelines have helped physicians to choose the most reasonable AED, although they cannot fully endorse new AEDs because of the lack of well-designed, randomized controlled trials. We review the mechanisms of action, pharmacokinetic properties, adverse reactions, efficacy, and tolerability of eight new AEDs (felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, topiramate, vigabatrin, and zonisamide), focusing on currently available treatment guidelines and expert opinions regarding pediatric epilepsy.
自1993年以来引入的新型抗癫痫药物（AEDs）为癫痫治疗提供了更多样化的选择。尽管这些药物疗效相当且耐受性更好，但仍有超过25%的患者对治疗无效。此外，儿科患者的问题与成人不同，在新型AEDs的研发和应用中尚未得到解决。最近发布的循证治疗指南有助于医生选择最合理的AED，尽管由于缺乏精心设计的随机对照试验，它们不能完全认可新型AEDs。我们综述了八种新型AEDs（非氨酯、加巴喷丁、拉莫三嗪、左乙拉西坦、奥卡西平、托吡酯、氨己烯酸和唑尼沙胺）的作用机制、药代动力学特性、不良反应、疗效和耐受性，重点关注目前可用的治疗指南以及关于小儿癫痫的专家意见。
