Tag Archives: Zonisamide

Pharmacological Treatment of Pain

While medications are often prescribed for all types of chronic pain, research has consistently shown that several classes have proven efficacy for the treatment of neuropathic pain. Ideally, pharmacotherapy of pain would be specifically selected on the basis of considerations of etiology (e.g., ischemic, neuropathic), pathophysiology (e.g., demyelination, central pain), and anatomy (e.g., C fibers,… Read More »

Chronic Illness: Current Therapies

The main goal of bipolar disorder drug treatment is to establish euthymia (stable mood with a persistent sense of well-being) without inducing mania or rapid cycling (i.e., four or more mood episodes in a 12-month period). For this reason, drug treatment usually consists of an agent or, more frequently, combinations of agents that exert both… Read More »

Specific Migraine-Preventive Agents: Anticonvulsants

Anticonvulsant medication is increasingly recommended for migraine prevention, because it was proved to be effective by placebo-controlled, double-blind trials. With the exceptions of valproic acid, topiramate, and zonisamide, anticonvulsants may interfere substantially with the efficacy of oral contraceptives. Nine controlled trials of five different anticonvulsants were included in the AHCPR Technical Report. Carbamazepine The only… Read More »

Treatment Of Childhood Absence Epilepsy

Childhood absence epilepsy (CAE) typically requires treatment because the seizures are frequent and interfere with normal cognitive functioning. International League Against Epilepsy Guidelines (Newly Diagnosed Epilepsy) According to the ILAE guidelines, the absence of class I and class II randomized controlled trials (RCTs) for children with absence seizures implies a marked deficiency in adequately powered,… Read More »

Treatment Of Juvenile Myoclonic Epilepsy

ILAE Guidelines (Newly Diagnosed Epilepsy) Despite being a relatively common syndrome, there are no randomized trials reporting efficacy or effectiveness as a primary outcome measure in newly diagnosed juvenile myoclonic epilepsy. Valproate has long been regarded as the drug of choice to treat this condition. ‘In the absence of class I, class II and class… Read More »

Treatment Of IGE With GTC Seizures Only

The syndrome of primary generalized-onset tonic–clonic seizures presents the clinician with nosologic, diagnostic and treatment difficulties. Some patients with IGE appear to have generalized-onset tonic–clonic seizures alone and the 1989 ILAE epilepsy classification individualized epilepsy with grand mal seizures on awakening and epilepsies with specific modes of precipitation. The evolving classification of IGE uses more… Read More »

Treatment Of Childhood Absence Epilepsy: American Academy Of Neurology Guidelines

New Anti-Epileptic Drugs Only American Academy of Neurology (AAN) guidelines evaluating efficacy of new anti-epileptic drugs state only that lamotrigine is effective in children with newly diagnosed absence seizures (level B recommendation). Ethosuximide After ethosuximide was described as effective in absence epilepsy in 1958, a number of open-label, non-comparative studies where ethosuximide was added to… Read More »

Treatment Of The Child Or Adolescent With Newly Diagnosed Epilepsy

Paediatric epilepsy is amazingly diverse. In some children, basic diagnosis, seizure classification and treatment are straightforward. Other patients have difficult-to-diagnose seizures, complicated seizure classification and a variable response to treatment. Some seizures are subclinical, others are barely noticeable, and occasionally they are life threatening. Many children with epilepsy have no associated disabilities, but all children… Read More »

Treatment of the epilepsy patient with hepatic disease

The liver is the principal organ of drug metabolism. Some drugs are absorbed from the gut, delivered to the liver and undergo first-pass metabolism prior to reaching the systemic circulation. Metabolism of these drugs is significantly affected by hepatic vascular supply; if hepatic blood flow is reduced, first-pass metabolism is decreased and more drug reaches… Read More »