Pharmacotherapy of epilepsy: state of the art and developments

PURPOSE: A discussion of modern day practice and new developments in antiepileptic drug treatment. CONTENTS: Important principles of antiepileptic therapy are addressed--starting with antiepileptic drug therapy, pharmacokinetics and pharmacodynamics, therapeutic drug monitoring, drug-induced adverse effects and the withdrawal of antiepileptic drugs. Furthermore, the pathophysiology of focal and generalized epilepsies and the mechanism of action of several antiepileptic drugs are briefly reviewed. Modern treatment algorithms for different types of epileptic seizures are presented. A significant development is the introduction of new antiepileptic drugs and particularly of those drugs that have been developed according to the latest insights into pathophysiology. Also of interest is the increased focus on adverse effects and on quality of life. Partly due to these developments, combining antiepileptic drugs has received renewed attention in an attempt to maintain effective seizure control but with a reduction of adverse effects.