Li L M, Nashef L, Moriarty J, Duncan J S, Sander J W
Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK.
Eur Neurol. 1996;36(3):146-8. doi: 10.1159/000117232.
Felbamate is a novel anti-epileptic drug (AED) which has recently been associated with reports of aplastic anaemia and liver failure. We have conducted an open-label add-on assessment of the tolerability and efficacy of this compound in 111 adult patients with refractory epilepsy attending a tertiary referral centre. The mean follow-up period was 4 months (range 1-8 months). Sixty-three (57%) were ongoing, 38 (34%) had discontinued felbamate and a further 10 (9%) were withdrawing. Reasons for discontinuing felbamate were adverse events in 23 (21%), increase in seizures in 11 (10%) and lack of efficacy in 14 (12%). Behavioural disturbances occurred in 14 patients, being the most likely adverse event to result in discontinuation. No cases of aplastic anaemia or liver failure were observed in this group. Felbamate appears to be a broad-spectrum AED. Seven percent of the patients had more than 95% seizure reduction (2 patients were seizure free), whilst a further 13% had significant improvement ( > 50% reduction in seizure frequency). In conclusion, felbamate seems to be an effective AED. In view of its association with potentially life-threatening complications, its use should however be restricted to patients with medically refractory epilepsy.
非氨酯是一种新型抗癫痫药物（AED），最近有关于它与再生障碍性贫血和肝衰竭的报道。我们对一家三级转诊中心的111例难治性癫痫成年患者进行了一项关于该化合物耐受性和疗效的开放标签附加评估。平均随访期为4个月（范围1 - 8个月）。63例（57%）仍在治疗，38例（34%）已停用非氨酯，另有10例（9%）正在停药。停用非氨酯的原因包括23例（21%）出现不良事件、11例（10%）癫痫发作增加和14例（12%）缺乏疗效。14例患者出现行为障碍，这是最有可能导致停药的不良事件。该组未观察到再生障碍性贫血或肝衰竭病例。非氨酯似乎是一种广谱抗癫痫药物。7%的患者癫痫发作减少超过95%（2例无癫痫发作），另有13%有显著改善（癫痫发作频率降低>50%）。总之，非氨酯似乎是一种有效的抗癫痫药物。然而，鉴于它与潜在的危及生命的并发症有关，其使用应仅限于药物难治性癫痫患者。
