Developments in antiepileptic drug therapy.

Development of new antiepileptic drugs has continued to progress, with both the evolution of new drugs, as well as new formulations of old drugs. It is hoped that, with advances in the understanding of the molecular basis of epilepsy, novel antiepileptic drugs will come about through design rather than serendipity. This article concentrates on a selection of the more promising antiepileptic drugs and reviews their recent progress. Felbamate, lamotrigine, vigabatrin, zonisamide, and gabapentin are already in clinical use in certain countries. Stiripentol and other potential antiepileptic drugs are also reviewed. In addition, there have been strategies to improve the pharmacokinetics of currently used antiepileptic drugs and we have concentrated on controlled-release carbamazepine and oxcarbazepine, both available in certain countries. It is, however, increasingly apparent that good comparative studies are needed before definitive advice can be given in the drug treatment of epilepsy.