Efficacy and tolerability of the new antiepileptic drugs II: Treatment of refractory epilepsy: Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society

J. A. French, A. M. Kanner, J. Bautista, B. Abou-Khalil, T. Browne, C. L. Harden, W. H. Theodore, C. Bazil, J. Stern, S. C. Schachter, D. Bergen, D. Hirtz, G. D. Montouris, M. Nespeca, B. Gidal, W. J. Marks, W. R. Turk, J. H. Fischer, B. Bourgeois, Andrew WilnerR. E. Faught, R. C. Sachdeo, A. Beydoun, T. A. Glauser

Research output: Contribution to journalReview article

398 Citations (Scopus)

Abstract

Objective: To assess the evidence demonstrating efficacy, tolerability, and safety of seven new antiepileptic drugs (AEDs) (gabapentin, lamotrigine, topiramate, tiagabine, oxcarbazepine, levetiracetam, and zonisamide) in the treatment of children and adults with refractory partial and generalized epilepsies. Methods: A 23-member committee including general neurologists, pediatric neurologists, epileptologists, and doctors in pharmacy evaluated the available evidence based on a structured literature review including MEDLINE, Current Contents, and Cochrane library for relevant articles from 1987 until March 2003. Results: All of the new AEDs were found to be appropriate for adjunctive treatment of refractory partial seizures in adults. Gabapentin can be effective for the treatment of mixed seizure disorders, and gabapentin, lamotrigine, oxcarbazepine, and topiramate for the treatment of refractory partial seizures in children. Limited evidence suggests that lamotrigine and topiramate are also effective for adjunctive treatment of idiopathic generalized epilepsy in adults and children, as well as treatment of the Lennox Gastaut syndrome. Conclusions: The choice of AED depends upon seizure and/or syndrome type, patient age, concomitant medications, AED tolerability, safety, and efficacy. The results of this evidence-based assessment provide guidelines for the prescription of AEDs for patients with refractory epilepsy and identify those seizure types and syndromes where more evidence is necessary.

Original languageEnglish (US)
Pages (from-to)1261-1273
Number of pages13
JournalNeurology
Volume62
Issue number8
DOIs
StatePublished - Apr 27 2004
Externally publishedYes

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Biomedical Technology Assessment
Anticonvulsants
Epilepsy
Seizures
zonisamide
etiracetam
Therapeutics
Committee Membership
Safety
Generalized Epilepsy
Partial Epilepsy
Prescription Drugs
MEDLINE
Libraries
Guidelines
Pediatrics
topiramate
gabapentin
lamotrigine

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Efficacy and tolerability of the new antiepileptic drugs II : Treatment of refractory epilepsy: Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. / French, J. A.; Kanner, A. M.; Bautista, J.; Abou-Khalil, B.; Browne, T.; Harden, C. L.; Theodore, W. H.; Bazil, C.; Stern, J.; Schachter, S. C.; Bergen, D.; Hirtz, D.; Montouris, G. D.; Nespeca, M.; Gidal, B.; Marks, W. J.; Turk, W. R.; Fischer, J. H.; Bourgeois, B.; Wilner, Andrew; Faught, R. E.; Sachdeo, R. C.; Beydoun, A.; Glauser, T. A.

In: Neurology, Vol. 62, No. 8, 27.04.2004, p. 1261-1273.

Research output: Contribution to journalReview article

French, JA, Kanner, AM, Bautista, J, Abou-Khalil, B, Browne, T, Harden, CL, Theodore, WH, Bazil, C, Stern, J, Schachter, SC, Bergen, D, Hirtz, D, Montouris, GD, Nespeca, M, Gidal, B, Marks, WJ, Turk, WR, Fischer, JH, Bourgeois, B, Wilner, A, Faught, RE, Sachdeo, RC, Beydoun, A & Glauser, TA 2004, 'Efficacy and tolerability of the new antiepileptic drugs II: Treatment of refractory epilepsy: Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society', Neurology, vol. 62, no. 8, pp. 1261-1273. https://doi.org/10.1212/01.WNL.0000123695.22623.32
French, J. A. ; Kanner, A. M. ; Bautista, J. ; Abou-Khalil, B. ; Browne, T. ; Harden, C. L. ; Theodore, W. H. ; Bazil, C. ; Stern, J. ; Schachter, S. C. ; Bergen, D. ; Hirtz, D. ; Montouris, G. D. ; Nespeca, M. ; Gidal, B. ; Marks, W. J. ; Turk, W. R. ; Fischer, J. H. ; Bourgeois, B. ; Wilner, Andrew ; Faught, R. E. ; Sachdeo, R. C. ; Beydoun, A. ; Glauser, T. A. / Efficacy and tolerability of the new antiepileptic drugs II : Treatment of refractory epilepsy: Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. In: Neurology. 2004 ; Vol. 62, No. 8. pp. 1261-1273.
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abstract = "Objective: To assess the evidence demonstrating efficacy, tolerability, and safety of seven new antiepileptic drugs (AEDs) (gabapentin, lamotrigine, topiramate, tiagabine, oxcarbazepine, levetiracetam, and zonisamide) in the treatment of children and adults with refractory partial and generalized epilepsies. Methods: A 23-member committee including general neurologists, pediatric neurologists, epileptologists, and doctors in pharmacy evaluated the available evidence based on a structured literature review including MEDLINE, Current Contents, and Cochrane library for relevant articles from 1987 until March 2003. Results: All of the new AEDs were found to be appropriate for adjunctive treatment of refractory partial seizures in adults. Gabapentin can be effective for the treatment of mixed seizure disorders, and gabapentin, lamotrigine, oxcarbazepine, and topiramate for the treatment of refractory partial seizures in children. Limited evidence suggests that lamotrigine and topiramate are also effective for adjunctive treatment of idiopathic generalized epilepsy in adults and children, as well as treatment of the Lennox Gastaut syndrome. Conclusions: The choice of AED depends upon seizure and/or syndrome type, patient age, concomitant medications, AED tolerability, safety, and efficacy. The results of this evidence-based assessment provide guidelines for the prescription of AEDs for patients with refractory epilepsy and identify those seizure types and syndromes where more evidence is necessary.",
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T1 - Efficacy and tolerability of the new antiepileptic drugs II

T2 - Treatment of refractory epilepsy: Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society

AU - French, J. A.

AU - Kanner, A. M.

AU - Bautista, J.

AU - Abou-Khalil, B.

AU - Browne, T.

AU - Harden, C. L.

AU - Theodore, W. H.

AU - Bazil, C.

AU - Stern, J.

AU - Schachter, S. C.

AU - Bergen, D.

AU - Hirtz, D.

AU - Montouris, G. D.

AU - Nespeca, M.

AU - Gidal, B.

AU - Marks, W. J.

AU - Turk, W. R.

AU - Fischer, J. H.

AU - Bourgeois, B.

AU - Wilner, Andrew

AU - Faught, R. E.

AU - Sachdeo, R. C.

AU - Beydoun, A.

AU - Glauser, T. A.

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N2 - Objective: To assess the evidence demonstrating efficacy, tolerability, and safety of seven new antiepileptic drugs (AEDs) (gabapentin, lamotrigine, topiramate, tiagabine, oxcarbazepine, levetiracetam, and zonisamide) in the treatment of children and adults with refractory partial and generalized epilepsies. Methods: A 23-member committee including general neurologists, pediatric neurologists, epileptologists, and doctors in pharmacy evaluated the available evidence based on a structured literature review including MEDLINE, Current Contents, and Cochrane library for relevant articles from 1987 until March 2003. Results: All of the new AEDs were found to be appropriate for adjunctive treatment of refractory partial seizures in adults. Gabapentin can be effective for the treatment of mixed seizure disorders, and gabapentin, lamotrigine, oxcarbazepine, and topiramate for the treatment of refractory partial seizures in children. Limited evidence suggests that lamotrigine and topiramate are also effective for adjunctive treatment of idiopathic generalized epilepsy in adults and children, as well as treatment of the Lennox Gastaut syndrome. Conclusions: The choice of AED depends upon seizure and/or syndrome type, patient age, concomitant medications, AED tolerability, safety, and efficacy. The results of this evidence-based assessment provide guidelines for the prescription of AEDs for patients with refractory epilepsy and identify those seizure types and syndromes where more evidence is necessary.

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