Difficulties in Treatment and Management of Epilepsy and Challenges in New Drug Development.docVIP

Pharmaceuticals 2010, 3, 2090-2110; doi:10.3390/ph3072090 OPEN ACCESS pharmaceuticals ISSN 1424-8247 /journal/pharmaceuticals Review Difficulties in Treatment and Management of Epilepsy and Challenges in New Drug Development Abdul Wahab Institute of Neurophysiology, Charité Berlin Medical University, Tucholskystrasse 2, D-10117 Berlin, Germany; E-Mail: abdul.wahab@charite.de; Tel.: +49 30 Fax: +49 30 450528962 Received: 10 June 2010; in revised form: 28 June 2010 / Accepted: 2 July 2010 / Published: 5 July 2010 Abstract: Epilepsy is a serious neurological disorder that affects around 50 million people worldwide. Almost 30% of epileptic patients suffer from pharmacoresistance, which is associated with social isolation, dependent behaviour, low marriage rates, unemployment, psychological issues and reduced quality of life. Currently available antiepileptic drugs have a limited efficacy, and their negative properties limit their use and cause difficulties in patient management. Antiepileptic drugs can provide only symptomatic relief as these drugs suppress seizures but do not have ability to cure epileptogenesis. The long term use of antiepileptic drugs is limited due to their adverse effects, withdrawal symptoms, deleterious interactions with other drugs and economic burden, especially in developing countries. Furthermore, some of the available antiepileptic drugs may even potentiate certain type of seizures. Several in vivo and in vitro animal models have been proposed and many new antiepileptic drugs have been marketed recently, but large numbers of patients are still pharmacoresistant. This review will highlight the difficulties in treatment and management of epilepsy and the limitations of available antiepileptic drugs and animal seizure models. Keywords: antiepileptic, anticonvulsant, seizure, pharmacoresistance, refractory seizures 1. Introduction Epilepsy is per