Felbamate: Consensus of current clinical experience

Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications

“…Multiple analytical methodologies have been reported for the measurement of felbamate in plasma/serum including HPLC [58,59], gas chromatography (GC) [60] and capillary electrophoresis [61]. However, the rare adverse effects have severely limited the use of felbamate [53]. Close monitoring of blood counts and liver function are advised during felbamate therapy.…”

Safety and Tolerability of Antiepileptic Drug Treatment in Children with Epilepsy

“…[93,94] Whether immune mechanisms play an important role in the toxicity of FBM metabolites is unclear, but their involvement is suggested by experimental studies on the immunogenic potential of reactive FBM metabolites [95] and the observation that patients with a history of hypersensitivity reactions and autoimmune disease are at greater risk of developing FBM-induced aplastic anaemia. [96] Off-target pharmacology: These reactions occur when a drug interacts directly with a system other than that for which it is intended. [97] Examples include some unusual CNS adverse effects such as Parkinsonian symptoms [98] or cognitive deterioration [99] with VPA, and dyskinesia with FBM.…”

Therapeutic Drug Monitoring of Antiepileptic Medications

“…Felbamate is approved in the United States for the treatment of partial seizures in adults and for Lennox-Gastaut Syndrome, a type of childhood epilepsy that is often refractory to AEM therapy (Bourgeois, 1997;Pellock et al, 2006). The use of felbamate has been limited due to the risks of aplastic anemia and severe liver failure, which led to revised labeling and restricted use of felbamate (Pellock et al, 2006).…”

“…The use of felbamate has been limited due to the risks of aplastic anemia and severe liver failure, which led to revised labeling and restricted use of felbamate (Pellock et al, 2006). It is suspected that one or more metabolites of felbamate mediate the rare but serious adverse effects (Shumaker et al, 1990).…”