Newer drugs for the treatment of epilepsy (Proceedings)


Newer drugs for the treatment of epilepsy (Proceedings)

Aug 01, 2010

For many years, short and long-term therapy of epileptic disorders in dogs and cats has been based on the use of benzodiazepines (e.g. diazepam), barbiturates (e.g. phenobarbital) and bromide, either individually or with different combinations. While phenobarbital and bromide are still widely used for the long-term therapy of epilepsy in dogs and cats, newer agents have become available that can be used as adjunctive or sole therapy. These drugs, approved for epilepsy in humans, have appropriate safety, efficacy and pharmacokinetic characteristics to become real alternatives in dogs and cats. Furthermore, some of them are available in generic form, making cost less of a concern. This paper discusses some of these new drug alternatives for epilepsy treatment.

Objectives of The Presentation

     1. To review current data on the safety and efficacy of newer antiepileptic agents in small animals.

Relevant Therapeutic Points

     1. The long-term objective of antiepileptic therapy is to reduce the frequency and intensity of seizures, keeping side effects as few as possible.
     2. Liver toxicity and excessive sedation are often major limiting factors of therapy.
     3. Treatment success depends more on owner compliance than any other variable. Good candidate drugs benefit from half-lives that are long enough for convenient dose intervals (e.g. once-a-day administration).
     4. For drugs with narrow safety margins, therapeutic drug monitoring (TDM) is often helpful to determine safe and effective individual doses. This requires definition of a therapeutic window as well as the availability of sensitive and inexpensive bioassays.
     5. Drug interactions may largely affect safety and efficacy of antiepileptic drugs.