Anticonvulsants/therapeutic use*

Anticonvulsants ; pharmacology ; therapeutic use ; Epilepsy ; drug therapy ; genetics ; Humans ; Pharmacogenetics

Anticonvulsants ; adverse effects ; therapeutic use ; Child ; Epilepsy ; drug therapy ; Humans

Epilepsy has high incidence and complex etiologies,and its treatment remains challenging.For around 70% of people with epilepsy,seizures can be controlled after proper antiepileptic treatment.The availability of some new antiepileptic drugs in recent years has offered new options for epileptic patients.A solid knowledge on the pharmacokinetics,efficacy,and tolerability profiles of these new antiepileptic drugs will help to provide safe,proper,reasonable,and standardized treatment for patients.
Anticonvulsants ; therapeutic use ; Epilepsy ; drug therapy ; Humans ; Seizures ; drug therapy

OBJECTIVETo investigate the efficacy and safety of lamotrigine monotherapy in children with epilepsy via a systematic review.

METHODSPubMed, Cochrane, CNKI, VIP, CBM, Wanfang Data were searched for randomized controlled trials (RCTs) of lamotrigine monotherapy in children with epilepsy. Literature screening, data extraction, and quality assessment were performed according to the method recommended by Cochrane Collaboration. RevMan 5.2 software was used to conduct the Meta analysis.

RESULTSA total of 9 RCTs involving 1 016 participants were included. Lamotrigine yielded a significantly lower complete control rate of seizure than ethosuximide, but the complete control rate of seizure showed no significant differences between lamotrigine and carbamazepine/sodium valproate. Patients treated with lamotrigine had a significantly lower incidence rate of adverse events than those treated with carbamazepine, but the incidence rate of adverse events showed no significant differences between patients treated with lamotrigine and sodium valproate/carbamazepine. The drop-out rate showed no significant differences between the three treatment groups.

CONCLUSIONSLamotrigine is an ideal alternative drug for children who do not respond to traditional antiepileptic medication or experience significant adverse reactions; however, more high-quality RCTs with a large sample size and a long follow-up time are needed to confirm these conclusions.

Anticonvulsants ; therapeutic use ; Epilepsy ; drug therapy ; Humans ; Randomized Controlled Trials as Topic ; Triazines ; adverse effects ; therapeutic use

Anticonvulsants ; therapeutic use ; Clonazepam ; therapeutic use ; Female ; Humans ; Levetiracetam ; therapeutic use ; MERRF Syndrome ; drug therapy ; Male ; Myoclonus ; drug therapy

OBJECTIVETo review the mechanisms and current clinical application of pharmacological interventions for phantom limb pain.

DATA SOURCESBoth Chinese and English language literatures were searched using MEDLINE (1982 - 2011), Pubmed (1982 - 2011) and the Index of Chinese Language Literature (1982 - 2011).

STUDY SELECTIONData from published articles about pharmacological management of phantom limb pain in recent domestic and foreign literature were selected. Data extraction Data were mainly extracted from 96 articles which are listed in the reference section of this review.

RESULTSBy reviewing the mechanisms and current clinical application of pharmacological interventions for phantom limb pain, including anticonvulsants, antidepressants, local anaesthetics, N-methyl-D-aspartate receptor antagonists, non-steroidal anti-inflammatory drugs, tramadol, opioids, calcitonin, capsaicin, beta-adrenergic blockers, clonidine, muscle relaxants, and emerging drugs, we examined the efficacy and safety of these medications, outlined the limitations and future directions.

CONCLUSIONSAlthough there is lack of evidence-based consensus guidelines for the pharmacological management of phantom limb pain, we recommend tricyclic antidepressants, gabapentin, tramadol, opioids, local anaesthetics and N-methyl-D-aspartate receptor antagonists as the rational options for the treatment of phantom limb pain.

Analgesics ; therapeutic use ; Analgesics, Opioid ; therapeutic use ; Anticonvulsants ; therapeutic use ; Antidepressive Agents ; therapeutic use ; Humans ; Phantom Limb ; drug therapy ; Tramadol ; therapeutic use

Anticonvulsants ; administration & dosage ; therapeutic use ; Drug Prescriptions ; Humans ; Off-Label Use

OBJECTIVETo study and compare the prophylatic efficacy of levetiracetam, valproate and phenobarbital on febrile convulsions in rats.

METHODSSixty Wistar rats were randomly administered with levetiracetam (200 mg/kg), valproate (250 mg/kg), phenobarbital (30 mg/kg) or normal saline (8 ml/kg) for 5 days. Five days later, febrile convulsions were induced by hyperthermal bath (45 Celcius degree). The latency, duration and the severity of seizures were observed.

RESULTSIn all the three drug-treated groups, the latency was significantly prolonged, and the duration and the severity of seizures were notably reduced compared with the saline group (P<0.05 or 0.01). The phenobarbital group had the shortest duration of seizures and the least severe seizures among the three drug-treated groups. There were no significant differences between the levetiracetam and valproate groups.

CONCLUSIONSContinuous administration of levetiracetam, valproate or phenobarbital is effective in preventing recurrent febrile convulsions in rats. Phenobarbital appears to be more effective than levetiracetam and valproate. There were no significant differences in the prophylactic efficacy between levetiracetam and valproate.

Animals ; Anticonvulsants ; therapeutic use ; Male ; Phenobarbital ; therapeutic use ; Piracetam ; analogs & derivatives ; therapeutic use ; Rats ; Recurrence ; Seizures, Febrile ; prevention & control ; Valproic Acid ; therapeutic use

BACKGROUNDRecently, new anti-epileptic drugs (AEDs) have been more frequently selected to treat epilepsy. In the present study, we evaluated the dynamic changes of efficacy and safety of three newer AEDs for treating partial epilepsy in China.

METHODSPatients were collected sequentially and were divided into three groups which accepted oxcarbazepine (OXC), lamotrigine (LTG) or topiramate (TPM) therapy. Each group included monotherapy and add-on therapy subgroups. We followed all patients for one year and recorded the indexes of efficacy and safety in detail.

RESULTSA total of 909 patients finished the follow-up observation. No significant difference was found in proportion of patients with > or = 50% reduction, > or = 75% reduction and 100% seizure reduction in the LTG and OXC groups between the first and the second six months. In the TPM group there was a statistical difference between the first and the second six months in proportion of patients with > or = 50% reduction (P = 0.002), > or = 75% reduction (P < 0.0001) and 100% seizure reduction (P = 0.009) in the monotherapy subgroup, and about > or = 75% reduction and 100% seizure reduction in the add-on therapy subgroup (P < 0.0001). The efficacy between the add-on and monotherapy subgroups showed a statistical difference. The safety of the three newer AEDs was good.

CONCLUSIONSThe three newer AEDs all showed good efficacy and tolerability for partial epilepsy. And the efficacy can be maintained for at least one year.

Anticonvulsants ; therapeutic use ; Carbamazepine ; analogs & derivatives ; therapeutic use ; China ; Epilepsies, Partial ; drug therapy ; Follow-Up Studies ; Fructose ; analogs & derivatives ; therapeutic use ; Humans ; Treatment Outcome ; Triazines ; therapeutic use