Brief history of anti‐seizure drug development

Abstract

SummaryThe mainstay of therapy for epilepsy is anti‐seizure drugs (ASDs, also referred to as anticonvulsants and anti‐epileptic medications). Through much of the past century, only a handful for ASDs were available for clinical use. However, with the creation of the U.S. National Institutes of Health/National Institute of Neurological Disorders and Stroke (NINDS)–sponsored Anticonvulsant Screening Program (ASP), coupled with the emergence of high‐throughput screening platforms and methodologies, and advances in our understanding of the fundamental neurobiology of epilepsy, ASD development has greatly accelerated over the past 25 years. More than 18 new ASDs have been approved for clinical use since the inception of the ASP. Despite this remarkable success and the emergence of drugs possessing more favorable pharmacokinetic profiles that act on novel molecular targets, there has been increasing recognition that the paradigms for drug discovery have not yielded significant improvements in therapeutic efficacy, and that disease modification (i.e., anti‐epileptogenesis), among other challenges, must be addressed. Thus, with the renewed framework and mission of improving the lives of people with epilepsy, the name of the ASP was changed to the Epilepsy Therapy Screening Program (ETSP). This review briefly summarizes the history of ASD development and outlines some of the challenges and opportunities for the next generation of drug therapies for the epilepsy field.

Decision-support-Systeme, Assistenzsysteme und Telemedizin in der Epileptologie

“…Hierunter fallen z. B. neue Erkenntnisse in der Genetik, welche zu personalisierten Therapieoptionen führen [42], die zunehmende Anzahl von Antikonvulsiva und die damit einhergehenden Kombinationsmöglichkeiten [31], die wachsende Anzahl autoimmunvermittelter Epilepsiesyndrome [7], ein besseres Verständnis über die prognostische Wertigkeit histopathologischer Befunde [22] oder die Möglichkeit, das Risiko beim Absetzen der Antikonvulsiva besser einzuschätzen [23]. Hierbei den Überblick zu bewahren, fällt Nichtexperten zwangsläufig zunehmend schwer.HiersetzenClinical-decision-support-Systeme (CDSS) an.…”

How to Find Candidate Drug-targets for Antiepileptogenic Therapy?

“…Epilepsy, a chronic paroxysmal brain disorder, is one of the most common disabling conditions around the world [ 1 ]. Since the first introduction of bromides for seizures in 1850, the modern treatment for epilepsy has passed nearly 170 years [ 2 ]. There are over 25 antiepileptic drugs (AEDs) have been currently available for patients [ 3 ].…”

Epilepsy Surgery in 2019 : A Time to Change

“…Thereafter, many compounds were validated with screening tools. However, there was a period of stagnation between the early 1960s and mid-1970s, when only two major ASDs (valproate and carbamazepine) were adopted [21]. In 1975, U.S. National Institutes of Health (NIH)/National Institute of Neurological Disorders and Stroke (NINDS) launched the Anticonvulsant Screening Program (ASP), a systematic screening program for potentially useful compounds.…”