Monotherapy Trials of New Antiepileptic Drugs

Beydoun, Ahmad

doi:10.1111/j.1528-1157.1997.tb05201.x

Cited by 69 publications

(35 citation statements)

References 14 publications

(4 reference statements)

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“…Monotherapy studies with gabapentin (GBP) have recently been completed (22). GBP was particularly well tolerated in add-on trials and in monotherapy comparisons with CBZ (23).…”

Section: Gabapentinmentioning

confidence: 99%

Monostars: An Aid to Choosing an Antiepileptic Drug as Monotherapy

Brodie

1999

Epilepsia

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Summary: This article describes a flexible, dynamic system for comparing antiepileptic drugs (AEDs) as monotherapy, taking into account the needs of the patient and the characteristics of the treatment. Because differences in efficacy between AEDs cannot readily be demonstrated in regulatory clinical trials, safety is of paramount importance. Each drug has been judged across 11 criteria. These include knowledge of mechanism of action, suitable pharmacokinetics, drug interactions, delineated range of efficacy, ease of titration, idiosyncratic reactions, sedative burden, neuropsychiatric profile, teratogenic potential, and the likelihood of producing long-term side effects. The final consideration relates to how "comfortable" the doctor is with prescribing the drug as monotherapy. Scores of -1 (drawback), 0 (neutralhnknown), or +1 (advantage) have been allocated under each category, depending on current knowledge and clinical experience. The sum of the individual scores determines the awarding of "stars." In addition, the positive and negative features of each AED, when used as monotherapy, are highlighted. A range of established and new AEDs has been examined using the "monostars" method, including phenobarbital, phenytoin, carbamazepine, sodium valproate, lamotrigine, gabapentin, oxcarbazepine, and vigabatrin. Scores can be adjusted as new information comes to light. Other agents can be added when suitable monotherapy data become available. This analysis supports the contention that choice of treatment in newly diagnosed epilepsy should take into consideration the patient's age, sex, general health, coexisting disabilities, concomitant medication, and life style. Seizure type, syndrome, and the AED's pharmacology, efficacy, and safety profile should also be considered. Because dosing is often modest, cost should rarely be the ovemding factor in choosing a drug for a patient with newly diagnosed epilepsy in the developed world. With these criteria, some of the newer AEDs have potentially more to offer the patient as monotherapy than do the established agents.

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“…Monotherapy studies with gabapentin (GBP) have recently been completed (22). GBP was particularly well tolerated in add-on trials and in monotherapy comparisons with CBZ (23).…”

Section: Gabapentinmentioning

confidence: 99%

Monostars: An Aid to Choosing an Antiepileptic Drug as Monotherapy

Brodie

1999

Epilepsia

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“…3) was first shown to be an effective anticonvulsant agent in different animal models of epilepsy [154]. In humans, it prevents partial and generalized tonicclonic seizures when prescribed as monotherapy or with other drugs [155][156][157]. In animal models, gabapentin appears to block nociceptive responses, producing analgesic effects, and to possess anxiolytic-like activity [158].…”

Section: Introductionmentioning

confidence: 99%

The Glutamate Hypothesis in ALS: Pathophysiology and Drug Development

Blasco¹,

Mavel²,

Corcia³

et al. 2014

CMC

139

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“…Monotherapy with antiepileptic drugs (AEDs) has been advocated as the preferred regimen for patients with epilepsy (1). However, Mattson et al (2) showed that AED monotherapy resulted in total seizure control in only 39% of the trial population after 1 year.…”

mentioning

confidence: 99%