Rational pharmacotherapy in epilepsy [Farmacoterapia racional en epilepsia]
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Overview
abstract
Epilepsy is one of the most common neurological disorders at any age. The risk of developing epilepsy during lifespan is around 3.2%25. Treatment of epilepsy is base on the etiology, seizures type, and provoking factors. The aim of the treatment is to maintain the patients free of seizures and to reintegrate them to their usual activities in the society (familiar, scholar, labor, etc.). For the current management of epilepsy we have several pharmacological possibilities that modify favorably the natural history of this disease. In ideal conditions, monotherapy with the most proper drug, in the minimal doses for a complete control of epilepsy should be prescribed. However, one third of patients does not respond adequately and required the addition of other(s) antiepileptic drugs giving rise to politherapy that increase the toxicity and adverse effects. In addition, when pharmacological therapy is insufficient some patients will require surgery (lobectomy, callosotomy, lesionectomy, etc.) or stimulation of central (deep stimulation) or peripheral nervous system (vagal nerve) or cetogenic diet. Therefore, refractory epilepsy to pharmacological management continue to be a true challenge and the rational use of epileptic drugs being the key for recovering the quality of life of the patient that has this unfortunate but fascinating disorder. The present review describes in detail the main guidelines in order to have a rational pharmacological antiepileptic therapy in the patient with epilepsy.
