Gabapentin: A new broad spectrum Antiepileptic Drug
Abstract
Epilepsy is one of the most serious disorders of the brain, affecting about 50 million people worldwide. Epilepsy leads to multiple interacting medical, psychological, economic and social consequences. Successful seizure control is very important in decreasing the psychosocial and economic costs of epilepsy. Yet, most therapies didn’t completely improve patients for numerous reasons. The most effective antiepileptic drugs (AEDs) include phenytoin, carbamazepine, valproic acid, phenobarbital, and primidone. Of the older AEDs, carbamazepine and valproic acid together bring a threat of hepatic toxicity and have been associated with fetal anomalies. Carbamazepine and phenytoin aggravate hypersensitivity reactions in a significant number of patients, and phenytoin is associated with chronic adverse events (AEs). Phenytoin, carbamazepine, phenobarbital, and primidone are hepatic enzyme inducers. Valproic acid, on the contrary, is a powerful hepatic inhibitor. The newer agents have fewer drug interactions and slight, if at all, effect on the CYP450 enzyme system and other metabolic pathways. One of these new agents was gabapentin (GBP). GBP, the new antiepileptic drug (AED) has a broad spectrum of anti-seizure effects, less adverse effects and less drug interaction. GBP has since achieved international acknowledgment, not for its antiepileptic properties, but also its effectiveness in the managing of acute and chronic pain syndromes, especially neuropathic pain. It is prescribed as an add-on medication for the treatment of patients aged >12 years with partial and secondary generalized tonic-clonic seizures and for children aged 3 to 12 years with partial seizures. It has been used for monotherapy in adults in 38 countries. Gabapentin is regarded as safe and tolerable with a promising pharmacokinetic profile and an extensive therapeutic index.
The present article reviews the available information that dealing with the long-standing efficiency and safety of gabapentin in the treatment of patients with epilepsy.
