drugs like elsicarbazepine are useful in the treatment of partial-onset
seizures, now referred to as focal seizures
is a drug that has been approved by the FDA for the treatment of focal
- Its once-a-day
dosage makes it convenient to use
- Other drugs
recently approved for focal seizures include brivaracetam, perampanel and
. A review on this and
other new treatments for focal seizures was published in the US Pharmacist
Focal seizures are
seizures that affect only a part of the body. During a focal seizure, the
patient may be fully conscious, in which case it is referred to as a focal
seizure without dyscognitive features
. In other cases where the patient is
unable to respond during the focal seizure and loses awareness of the
environment, the seizure is called a focal seizure with dyscognitive
. Patients with dyscognitive seizures remain disoriented for some
time following the seizure.
‘Elsicarbazepine is a novel once-a-day option for the treatment of focal seizures.’
It must be noted that
not all people who suffer from seizures suffer from epilepsy
. Epilepsy is said to be present if the
patient suffers from two unprovoked seizures more than 24 hours apart, or one
unprovoked seizure with a high chance of developing more over the next 10
years, or is diagnosed with an epilepsy syndrome.
Medications that are
used in the treatment of focal seizures include the older drugs like carbamazepine
as well as the relatively
newer drugs levetiracetam
, topiramate, vigabatrin
The article discussed
some of the newly approved drugs approved for the treatment of focal seizures, which
are mentioned below:
Elsicarbazepine is similar to the older
anti-epileptics carbamazepine and oxcarbazepine in structure and mechanism of
action. Some of its characteristics include the following:
does not induce its own metabolism but can interact with other treatments
that the patient takes including oral contraceptives, warfarin, any
statins or clopidogrel.
- Its dosage should
be reduced to half in patients with moderate-to-severe kidney failure. It
should not be used in patients with severe liver disease.
- It is
administered once a day, which is very convenient for the patient. The initial
dosage is 400 mg per day which can be increased to 800 to 1600 mg/day.
- Side effects
include dizziness, drowsiness, nausea, headache, vomiting, fatigue,
blurred vision, double vision, tremors, rash and reduced blood sodium
levels. It may also damage the liver and cause thyroid hormone
- The medication
should be tapered down slowly when it is decided to reduce the dosage to
prevent withdrawal symptoms.
Other newer drugs that
have recently obtained approval for the treatment of focal seizures include:
Brivaracetam, which is
similar to levetiracetam, perampanel and lacosamide. Another drug ezogabine can
cause permanent vision loss and is therefore approved only for those patients
who have failed other treatments for focal seizures, and in whom the benefit of
taking the medication outweighs the risk.
The authors also
emphasize the importance of the pharmacist in epilepsy treatment. Once the drug
is prescribed for the treatment of epilepsy, the pharmacist could counsel the
patient to ensure that the patient takes the medication correctly to achieve
maximum benefit of the treatment.
- Barton L, Gore L, Hornekar J, Hilaire M. Eslicarbazepine and Other Treatment Advances for Focal Seizures. US Pharm. 2017;42(1):HS21-HS24