Overweg J
Instituut voor Epilepsiebestrijding Meer en Bosch, De Cruquiushoeve, Heemstede.
Ned Tijdschr Geneeskd. 1998 Feb 7;142(6):289-93.
Despite introduction of new antiepileptic drugs the established drugs phenytoin, carbamazepine and valproate still provide the treatment of choice in most forms of epilepsy, being efficacious in approximately two-thirds of all newly referred patients. In 20-60% of patients resistant to treatment with the older drugs, a 50% reduction of seizure frequency can be achieved by adding ethosuximide, clobazam, vigabatrine, oxcarbazepine, lamotrigine, felbamate, tiagabine or topiramate to the classic treatment. The majority of the new drugs are free of the problematic enzyme induction of the older compounds, making monotherapy as well as combination therapy much easier. To what extent the new antiepileptic drugs are going to be used for the treatment of patients with epilepsy will depend on the analysis of cost and benefits. This will be based on efficacy, side effects, interactions and teratogenicity of these new compounds.
尽管引入了新的抗癫痫药物，但苯妥英、卡马西平和丙戊酸盐等已确立的药物在大多数癫痫类型的治疗中仍是首选，对大约三分之二新转诊患者有效。在20%至60%对旧药治疗耐药的患者中，通过在经典治疗中添加乙琥胺、氯巴占、氨己烯酸、奥卡西平、拉莫三嗪、非氨酯、噻加宾或托吡酯，可使癫痫发作频率降低50%。大多数新药不存在旧化合物中存在的问题性酶诱导作用，使单药治疗和联合治疗都更加容易。新抗癫痫药物在多大程度上用于癫痫患者的治疗将取决于成本效益分析。这将基于这些新化合物的疗效、副作用、相互作用和致畸性。
