Introduction: Several antiepileptic drugs are available for the treatment ofepileptic patients. However, the treatment of some seizure types and noveldrug formulations deserve further advances in epilepsy research.Areas covered: The authors analyze the published evidence on the efficacy ofperampanel against secondarily generalized seizures (SGS) and report thecurrently available development of intravenous (IV) formulations ofcarbamazepine (CBZ), commenting on their potential in the clinical setting.Expert opinion: Perampanel is the first noncompetitive AMPA receptor antagonistto be approved as adjunctive treatment in patients with partial-onset(focal) seizures (POS) with or without secondary generalization. Apart fromits efficacy and safety on POS, a consistent body of evidence supports its efficacyin SGS at a minimum dose of 8 mg/day; however, such dose appears closeto the best-tolerated dose. CBZ is a poorly water-soluble compound; manyefforts to develop a parenteral formulation have not been successful so far.Novel IV CBZ formulations seem to exhibit favorable pharmacokinetics alongwith good tolerability in animal models and in patients taking oral CBZ.Further studies are needed to assess whether larger doses will be as well tolerated,allowing IV CBZ to be used as bridge therapy when the oral route is not feasible or in patients naive to CBZ.
Perspective on the use of perampanel and intravenous carbamazepine for generalized seizures. Expert Opin Pharmacother. 2014 Jan 17. [Epub ahead of print] PubMed PMID: 24437529.
Franco V;Citraro R;De Sarro G;Russo E.
2014-01-01
Abstract
Introduction: Several antiepileptic drugs are available for the treatment ofepileptic patients. However, the treatment of some seizure types and noveldrug formulations deserve further advances in epilepsy research.Areas covered: The authors analyze the published evidence on the efficacy ofperampanel against secondarily generalized seizures (SGS) and report thecurrently available development of intravenous (IV) formulations ofcarbamazepine (CBZ), commenting on their potential in the clinical setting.Expert opinion: Perampanel is the first noncompetitive AMPA receptor antagonistto be approved as adjunctive treatment in patients with partial-onset(focal) seizures (POS) with or without secondary generalization. Apart fromits efficacy and safety on POS, a consistent body of evidence supports its efficacyin SGS at a minimum dose of 8 mg/day; however, such dose appears closeto the best-tolerated dose. CBZ is a poorly water-soluble compound; manyefforts to develop a parenteral formulation have not been successful so far.Novel IV CBZ formulations seem to exhibit favorable pharmacokinetics alongwith good tolerability in animal models and in patients taking oral CBZ.Further studies are needed to assess whether larger doses will be as well tolerated,allowing IV CBZ to be used as bridge therapy when the oral route is not feasible or in patients naive to CBZ.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
