Wilson E A, Brodie M J
Department of Medicine and Therapeutics, Western Infirmary, Glasgow, Scotland, UK.
Baillieres Clin Neurol. 1996 Dec;5(4):723-47.
No fewer than eight new antiepileptic drugs (AEDs) with diverse mechanisms of action have been introduced into clinical practice in the 1990s. Short monographs on lamotrigine, vigabatrin, gabapentin, oxcarbazepine, felbamate, topiramate and vigabatrin have been prepared for this review. Details are provided of mechanisms of action, clinical pharmacokinetics and adverse drug interactions. Each section concentrates on the efficacy, tolerability and practical use of these drugs. The areas where they have potential for superiority over the established AEDs have been highlighted. Specific indications and dosage schedules have been provided. As many of these AEDs have, as yet, limited licences, an attempt has been made to identify ongoing studies and important omissions. Where possible, the eventual place of the new agent in the pharmacological management of epilepsy has been assessed. A more limited summary has been included of zonisamide which, although licensed in Japan, is still regarded as an investigational drug elsewhere. Short discussions of three of the most promising investigational compounds, namely remacemide, losigamone and levetiracetam, complete the picture.
20世纪90年代，至少有8种作用机制各异的新型抗癫痫药物（AEDs）被应用于临床实践。本综述针对拉莫三嗪、氨己烯酸、加巴喷丁、奥卡西平、非氨酯、托吡酯和氨己烯酸撰写了简短的专论。文中详细介绍了这些药物的作用机制、临床药代动力学及药物不良反应相互作用。每个章节都聚焦于这些药物的疗效、耐受性及实际应用。文中突出了它们相较于现有抗癫痫药物可能具有优势的领域。还给出了具体的适应证和用药方案。由于这些抗癫痫药物中有许多目前获批的适应证有限，因此本文尝试找出正在进行的研究及重要的遗漏之处。在可能的情况下，评估了这些新药在癫痫药物治疗中的最终地位。对唑尼沙胺进行了较为简略的总结，该药虽在日本已获批，但在其他地方仍被视为研究性药物。最后简短讨论了3种最具前景的研究性化合物，即瑞玛西胺、洛西加莫和左乙拉西坦。
