Matching articles for "antiepileptics"

Ganaxolone (Ztalmy) for CDKL5 Deficiency Disorder (online only)

   
The Medical Letter on Drugs and Therapeutics • August 19, 2024;  (Issue 1709)
The FDA has approved ganaxolone (Ztalmy – Marinus) for oral treatment of seizures associated with cyclin-dependent kinase-like 5 (CDKL5) deficiency disorder in patients ≥2 years old. It is the first drug...
The FDA has approved ganaxolone (Ztalmy – Marinus) for oral treatment of seizures associated with cyclin-dependent kinase-like 5 (CDKL5) deficiency disorder in patients ≥2 years old. It is the first drug to be approved in the US for this indication.
Med Lett Drugs Ther. 2024 Aug 19;66(1709):e139-40 | Show Full IntroductionHide Full Introduction

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • August 5, 2024;  (Issue 1708)
When used for the appropriate seizure type, antiseizure medications (ASMs) are roughly equivalent in efficacy. In addition to the seizure type, the choice of drug is usually based on factors such as ease of...
When used for the appropriate seizure type, antiseizure medications (ASMs) are roughly equivalent in efficacy. In addition to the seizure type, the choice of drug is usually based on factors such as ease of use, spectrum of activity, adverse effects, interactions with other drugs, presence of comorbid conditions, suitability for elderly persons and those with childbearing potential, and cost. Treatment should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures persist, expert clinicians generally try at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs at the same time.
Med Lett Drugs Ther. 2024 Aug 5;66(1708):121-8 | Show Full IntroductionHide Full Introduction

Brexpiprazole (Rexulti) for Agitation in Alzheimer's Dementia

   
The Medical Letter on Drugs and Therapeutics • June 26, 2023;  (Issue 1679)
The FDA has approved the oral second-generation antipsychotic drug brexpiprazole (Rexulti – Otsuka/Lundbeck) for once-daily treatment of agitation associated with dementia due to Alzheimer's disease...
The FDA has approved the oral second-generation antipsychotic drug brexpiprazole (Rexulti – Otsuka/Lundbeck) for once-daily treatment of agitation associated with dementia due to Alzheimer's disease (AD). Brexpiprazole is the first drug to be approved in the US for this indication. It is also approved for treatment of schizophrenia and as an adjunct to antidepressants for treatment of major depressive disorder.
Med Lett Drugs Ther. 2023 Jun 26;65(1679):99-101 | Show Full IntroductionHide Full Introduction

Comparison Table: Some Drugs for Migraine Prevention in Adults (online only)

   
The Medical Letter on Drugs and Therapeutics • June 12, 2023;  (Issue 1678)
...
View the Comparison Table: Some Drugs for Migraine Prevention in Adults
Med Lett Drugs Ther. 2023 Jun 12;65(1678):e100-2 | Show Full IntroductionHide Full Introduction

Drugs for Migraine

   
The Medical Letter on Drugs and Therapeutics • June 12, 2023;  (Issue 1678)
An oral nonopioid analgesic is often sufficient for acute treatment of mild to moderate migraine pain without severe nausea or vomiting. A triptan is the drug of choice for treatment of moderate to...
An oral nonopioid analgesic is often sufficient for acute treatment of mild to moderate migraine pain without severe nausea or vomiting. A triptan is the drug of choice for treatment of moderate to severe migraine in most patients without vascular disease. Treatment of pain when it is still mild to moderate in intensity improves headache response and reduces the risk of recurrence.
Med Lett Drugs Ther. 2023 Jun 12;65(1678):89-96 | Show Full IntroductionHide Full Introduction

Nonopioid Drugs for Pain

   
The Medical Letter on Drugs and Therapeutics • March 7, 2022;  (Issue 1645)
Nonopioid drugs can be used in the treatment of many nociceptive and neuropathic pain conditions. For severe pain, especially severe chronic cancer pain, use of opioids may be necessary....
Nonopioid drugs can be used in the treatment of many nociceptive and neuropathic pain conditions. For severe pain, especially severe chronic cancer pain, use of opioids may be necessary. Noninvasive nonpharmacologic treatments, including physical and psychological therapies, have been shown to improve pain and function in patients with some common chronic pain conditions and are unlikely to cause serious harms. A multimodal approach to analgesic therapy can increase pain control while reducing opioid use and adverse effects.
Med Lett Drugs Ther. 2022 Mar 7;64(1645):33-40 | Show Full IntroductionHide Full Introduction

Stiripentol (Diacomit) for Dravet Syndrome (online only)

   
The Medical Letter on Drugs and Therapeutics • March 24, 2021;  (Issue 1620)
The FDA has approved stiripentol (Diacomit – Biocodex) for treatment of seizures in patients ≥2 years old with Dravet syndrome who are also taking clobazam (Onfi). Stiripentol, which has been available...
The FDA has approved stiripentol (Diacomit – Biocodex) for treatment of seizures in patients ≥2 years old with Dravet syndrome who are also taking clobazam (Onfi). Stiripentol, which has been available in Europe, Canada, and Japan for many years, is the second drug to be approved in the US for this indication; cannabidiol oral solution (Epidiolex), a purified marijuana product, was the first.
Med Lett Drugs Ther. 2021 Mar 24;63(1620):e1-3 | Show Full IntroductionHide Full Introduction

Drugs for Migraine

   
The Medical Letter on Drugs and Therapeutics • October 5, 2020;  (Issue 1608)
An oral nonopioid analgesic is often sufficient for acute treatment of mild to moderate migraine headache without severe nausea or vomiting. A triptan is the drug of choice for treatment of moderate to...
An oral nonopioid analgesic is often sufficient for acute treatment of mild to moderate migraine headache without severe nausea or vomiting. A triptan is the drug of choice for treatment of moderate to severe migraine headache pain in most patients without vascular disease. Early treatment of pain when it is still mild to moderate in intensity improves headache response and reduces the risk of recurrence.
Med Lett Drugs Ther. 2020 Oct 5;62(1608):153-60 | Show Full IntroductionHide Full Introduction

Cenobamate (Xcopri) for Focal Seizures

   
The Medical Letter on Drugs and Therapeutics • August 24, 2020;  (Issue 1605)
The FDA has approved cenobamate (Xcopri – SK Life Science) for oral treatment of partial-onset (focal) seizures in...
The FDA has approved cenobamate (Xcopri – SK Life Science) for oral treatment of partial-onset (focal) seizures in adults.
Med Lett Drugs Ther. 2020 Aug 24;62(1605):134-6 | Show Full IntroductionHide Full Introduction

Intranasal Diazepam (Valtoco) and Midazolam (Nayzilam) for Seizure Clusters

   
The Medical Letter on Drugs and Therapeutics • April 20, 2020;  (Issue 1596)
The FDA has approved nasal spray formulations of the benzodiazepines diazepam (Valtoco — Neurelis) and midazolam (Nayzilam — UCB) for acute treatment of intermittent episodes of frequent seizure...
The FDA has approved nasal spray formulations of the benzodiazepines diazepam (Valtoco — Neurelis) and midazolam (Nayzilam — UCB) for acute treatment of intermittent episodes of frequent seizure activity (seizure clusters). Diazepam rectal gel (Diastat, Diastat AcuDial, and generics) has been used for this indication for many years.
Med Lett Drugs Ther. 2020 Apr 20;62(1596):63-4 | Show Full IntroductionHide Full Introduction

Cannabis and Cannabinoids

   
The Medical Letter on Drugs and Therapeutics • November 18, 2019;  (Issue 1585)
Cannabis (marijuana) contains more than 60 pharmacologically active cannabinoids; delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the best known. THC is the main psychoactive constituent of...
Cannabis (marijuana) contains more than 60 pharmacologically active cannabinoids; delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the best known. THC is the main psychoactive constituent of cannabis. CBD, unlike THC, does not produce intoxication or euphoria.
Med Lett Drugs Ther. 2019 Nov 18;61(1585):179-82 | Show Full IntroductionHide Full Introduction

Drugs for Chronic Insomnia

   
The Medical Letter on Drugs and Therapeutics • December 17, 2018;  (Issue 1562)
Cognitive behavioral therapy for insomnia (CBT-I) is recommended for initial treatment of chronic insomnia. Pharmacologic treatment should be used in addition to CBT-I when CBT-I alone is not...
Cognitive behavioral therapy for insomnia (CBT-I) is recommended for initial treatment of chronic insomnia. Pharmacologic treatment should be used in addition to CBT-I when CBT-I alone is not effective.
Med Lett Drugs Ther. 2018 Dec 17;60(1562):201-5 | Show Full IntroductionHide Full Introduction

Cannabidiol (Epidiolex) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • November 5, 2018;  (Issue 1559)
The FDA has approved cannabidiol oral solution (Epidiolex – Greenwich Biosciences) for treatment of seizures associated with Dravet syndrome or Lennox-Gastaut syndrome in patients ≥2 years...
The FDA has approved cannabidiol oral solution (Epidiolex – Greenwich Biosciences) for treatment of seizures associated with Dravet syndrome or Lennox-Gastaut syndrome in patients ≥2 years old. Cannabidiol (CBD) is a cannabinoid constituent of the marijuana plant (Cannabis sativa). It is the first natural marijuana product to be approved by the FDA for any indication and the first drug to be approved in the US for treatment of Dravet syndrome. Stiripentol (Diacomit), which is not a marijuana product, was also recently approved by the FDA for treatment of Dravet syndrome in combination with clobazam (Onfi) and will be reviewed in a future issue.
Med Lett Drugs Ther. 2018 Nov 5;60(1559):182-4 | Show Full IntroductionHide Full Introduction

Erenumab (Aimovig) for Migraine Prevention

   
The Medical Letter on Drugs and Therapeutics • June 18, 2018;  (Issue 1549)
The FDA has approved erenumab-aooe (Aimovig – Amgen/Novartis), a once-monthly, subcutaneously-injected, monoclonal antibody against the calcitonin gene-related peptide receptor, for preventive...
The FDA has approved erenumab-aooe (Aimovig – Amgen/Novartis), a once-monthly, subcutaneously-injected, monoclonal antibody against the calcitonin gene-related peptide receptor, for preventive treatment of migraine in adults. It is the first drug in its class to be approved by the FDA.
Med Lett Drugs Ther. 2018 Jun 18;60(1549):101-3 | Show Full IntroductionHide Full Introduction

In Brief: A Potentially Fatal Immune Reaction to Lamotrigine

   
The Medical Letter on Drugs and Therapeutics • June 18, 2018;  (Issue 1549)
The FDA has warned that the antiepileptic and mood-stabilizing drug lamotrigine (Lamictal, and generics) can rarely cause hemophagocytic lymphohistiocytosis (HLH), a serious and potentially fatal immune-related...
The FDA has warned that the antiepileptic and mood-stabilizing drug lamotrigine (Lamictal, and generics) can rarely cause hemophagocytic lymphohistiocytosis (HLH), a serious and potentially fatal immune-related reaction.1

HLH, which can be familial, occurs most often in infants, but can occur at any age. Often induced by Epstein-Barr Virus infection (HIV infection and non-Hodgkin's lymphoma are other common triggers), HLH is characterized by an unremitting activation of CD8+ T cells and macrophages.2 If untreated, it causes organ damage, particularly in the liver, bone marrow, and CNS; organ failure and death occur within months after onset.3 Clinical features can include fever and rash, splenomegaly, hepatitis, cytopenias, elevated triglyceride levels or low fibrinogen levels, hyperferritinemia, hemophagocytosis, decreased or absent natural killer cell activity, and elevated blood CD25 levels.4

The optimal treatment for drug-induced HLH is unclear. Treatment of HLH generally involves use of corticosteroids and blood products, sometimes augmented by aggressive immunosuppression with the cytotoxic drug etoposide (Toposar, and generics). The anti-CD52 antibody alemtuzumab (Lemtrada) can be added in refractory HLH cases,5 and allogeneic hematopoietic cell transplantation has been used in genetic cases.

Since lamotrigine first became available in 1994, five confirmed and three suspected cases of HLH associated with its use have been reported. All of these cases occurred within 24 days of starting treatment and required hospitalization. One death was reported; in the other cases, improvement occurred after discontinuation of lamotrigine and treatment of HLH. Because initial signs and symptoms of HLH are nonspecific, the condition can be confused with Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), another potentially fatal, multiorgan, immune-related adverse reaction associated with lamotrigine use.1,6

Patients being treated successfully with lamotrigine should continue taking it. Clinicians should monitor patients taking lamotrigine for signs and symptoms of HLH, especially during the first few weeks after starting the drug.

  1. FDA Drug Safety Communication: FDA warns of serious immune system reaction with seizure and mental health medicine lamotrigine (Lamictal). Available at: www.fda.gov. Accessed June 7, 2018.
  2. M Ramos-Casals et al. Adult haemophagocytic syndrome. Lancet 2014; 383:1503.
  3. SA Parikh et al. Prognostic factors and outcomes of adults with hemophagocytic lymphohistiocytosis. Mayo Clin Proc 2014; 89:484.
  4. JI Henter et al. HLH-2004: Diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer 2007; 48:124.
  5. RA Marsh et al. Salvage therapy of refractory hemophagocytic lymphohistiocytosis with alemtuzumab. Pediatr Blood Cancer 2013; 60:101.
  6. SH Kardaun et al. Drug reaction with eosinophilia and systemic symptoms (DRESS): an original multisystem adverse drug reaction. Results from the prospective RegiSCAR study. Br J Dermatol 2013; 169:1071.


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Med Lett Drugs Ther. 2018 Jun 18;60(1549):105 | Show Full IntroductionHide Full Introduction

Nonopioid Drugs for Pain

   
The Medical Letter on Drugs and Therapeutics • February 12, 2018;  (Issue 1540)
Nonopioid drugs can be used in the treatment of many nociceptive and neuropathic pain conditions. Use of opioids for pain will be reviewed in a future...
Nonopioid drugs can be used in the treatment of many nociceptive and neuropathic pain conditions. Use of opioids for pain will be reviewed in a future issue.
Med Lett Drugs Ther. 2018 Feb 12;60(1540):24-32 | Show Full IntroductionHide Full Introduction

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • July 31, 2017;  (Issue 1526)
Treatment of epilepsy should begin with a single antiepileptic drug (AED), increasing its dosage gradually until seizures are controlled or adverse effects become intolerable. If seizures...
Treatment of epilepsy should begin with a single antiepileptic drug (AED), increasing its dosage gradually until seizures are controlled or adverse effects become intolerable. If seizures persist, specialists generally recommend trying at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs concurrently. When used for the appropriate seizure type, AEDs are roughly equivalent in efficacy. Drug choice is usually based on factors such as ease of use, adverse effects, drug interactions, presence of comorbidities, and cost.
Med Lett Drugs Ther. 2017 Jul 31;59(1526):121-30 | Show Full IntroductionHide Full Introduction

Comparison Table: Some Oral Antiepileptic Drugs (online only)

   
The Medical Letter on Drugs and Therapeutics • July 31, 2017;  (Issue 1526)
...
View the Comparison Table: Some Oral Antiepileptic Drugs
Med Lett Drugs Ther. 2017 Jul 31;59(1526):e130-6 | Show Full IntroductionHide Full Introduction

Drugs for Migraine

   
The Medical Letter on Drugs and Therapeutics • February 13, 2017;  (Issue 1514)
An oral nonopioid analgesic may be sufficient for treatment of mild to moderate migraine without severe nausea or vomiting. A triptan is the drug of choice for treatment of moderate to severe migraine. Use...
An oral nonopioid analgesic may be sufficient for treatment of mild to moderate migraine without severe nausea or vomiting. A triptan is the drug of choice for treatment of moderate to severe migraine. Use of a triptan early in an attack when pain is still mild to moderate in intensity improves headache response and reduces recurrence rates.
Med Lett Drugs Ther. 2017 Feb 13;59(1514):27-32 | Show Full IntroductionHide Full Introduction

Comparison Table: Some Drugs for Migraine Prevention in Adults (online only)

   
The Medical Letter on Drugs and Therapeutics • February 13, 2017;  (Issue 1514)
...
View the Comparison Table: Some Drugs for Migraine Prevention in Adults
Med Lett Drugs Ther. 2017 Feb 13;59(1514):e31-2 | Show Full IntroductionHide Full Introduction

Drugs for Bipolar Disorder

   
The Medical Letter on Drugs and Therapeutics • August 15, 2016;  (Issue 1501)
Bipolar disorder is characterized by intermittent episodes of mania and/or depression. Even with maintenance treatment, recurrences of manic or (more frequently) depressive episodes are common. Some of the...
Bipolar disorder is characterized by intermittent episodes of mania and/or depression. Even with maintenance treatment, recurrences of manic or (more frequently) depressive episodes are common. Some of the drugs and dosages recommended here have not been approved by the FDA for use in bipolar disorder.
Med Lett Drugs Ther. 2016 Aug 15;58(1501):103-6 | Show Full IntroductionHide Full Introduction

Cannabis and Cannabinoids

   
The Medical Letter on Drugs and Therapeutics • August 1, 2016;  (Issue 1500)
In the US, 25 states and the District of Columbia now permit some medical use of botanical marijuana (Cannabis sativa). It has been used for centuries to treat various ailments, but non-standardization of...
In the US, 25 states and the District of Columbia now permit some medical use of botanical marijuana (Cannabis sativa). It has been used for centuries to treat various ailments, but non-standardization of dosage makes available data difficult to interpret. Cannabis contains >60 pharmacologically active cannabinoids.
Med Lett Drugs Ther. 2016 Aug 1;58(1500):97-8 | Show Full IntroductionHide Full Introduction

Brivaracetam (Briviact) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • July 18, 2016;  (Issue 1499)
Brivaracetam (Briviact – UCB), an analog of levetiracetam (Keppra, and others), has been approved by the FDA for adjunctive treatment of partial-onset seizures in patients ≥16 years old. New drugs...
Brivaracetam (Briviact – UCB), an analog of levetiracetam (Keppra, and others), has been approved by the FDA for adjunctive treatment of partial-onset seizures in patients ≥16 years old. New drugs for epilepsy are often approved initially only as adjunctive treatment for partial seizures.
Med Lett Drugs Ther. 2016 Jul 18;58(1499):95-6 | Show Full IntroductionHide Full Introduction

Spritam - A New Formulation of Levetiracetam for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • June 20, 2016;  (Issue 1497)
The FDA has approved a rapidly disintegrating tablet formulation of the antiepileptic drug levetiracetam (Spritam – Aprecia) for adjunctive treatment of partialonset, myoclonic, and primary generalized...
The FDA has approved a rapidly disintegrating tablet formulation of the antiepileptic drug levetiracetam (Spritam – Aprecia) for adjunctive treatment of partialonset, myoclonic, and primary generalized tonicclonic seizures. Oral and intravenous formulations of levetiracetam (Keppra, and generics) have been available for years. Although approved by the FDA only as adjunctive therapy, levetiracetam is commonly used as monotherapy for partial-onset and generalized seizures and may also be effective in treating absence seizures and seizures of Lennox-Gastaut syndrome.
Med Lett Drugs Ther. 2016 Jun 20;58(1497):78-9 | Show Full IntroductionHide Full Introduction

Drugs for Insomnia

   
The Medical Letter on Drugs and Therapeutics • July 6, 2015;  (Issue 1472)
Pharmacological treatment of insomnia includes prescription drugs, non-prescription medications, and "natural" remedies. Behavioral approaches such as cognitive behavioral therapy, which are not...
Pharmacological treatment of insomnia includes prescription drugs, non-prescription medications, and "natural" remedies. Behavioral approaches such as cognitive behavioral therapy, which are not discussed here, are also used. Pharmacologic treatment and behavioral therapy are often combined.
Med Lett Drugs Ther. 2015 Jul 6;57(1472):95-8 | Show Full IntroductionHide Full Introduction

Diet, Drugs, and Surgery for Weight Loss

   
The Medical Letter on Drugs and Therapeutics • February 16, 2015;  (Issue 1462)
Adults with a body mass index (BMI) between 25 and 29.9 kg/m2 are considered overweight. Those with a BMI ≥30 are considered obese. Losing even a small amount of weight and increasing physical activity...
Adults with a body mass index (BMI) between 25 and 29.9 kg/m2 are considered overweight. Those with a BMI ≥30 are considered obese. Losing even a small amount of weight and increasing physical activity can prevent some of the complications of obesity, particularly type 2 diabetes. Diet and exercise are the preferred methods for losing weight, but long-term failure rates are high. Several drugs have been approved by the FDA for weight reduction, but adherence is poor, adverse effects are common, and patients usually regain the lost weight when the drug is stopped. Bariatric surgery can produce substantial weight loss and significantly reduce obesity-related comorbidities; long-term data on its safety are encouraging, but still limited. Guidelines for the management of overweight or obese adults have recently been published.
Med Lett Drugs Ther. 2015 Feb 16;57(1462):21-8 | Show Full IntroductionHide Full Introduction

In Brief: Topiramate Extended-Release Capsules (Qudexy XR) (online only)

   
The Medical Letter on Drugs and Therapeutics • December 8, 2014;  (Issue 1457)
The FDA has approved a new extended-release capsule formulation of topiramate (Qudexy XR – Upsher Smith), which can be opened and sprinkled on food for patients who have difficulty swallowing tablets or...
The FDA has approved a new extended-release capsule formulation of topiramate (Qudexy XR – Upsher Smith), which can be opened and sprinkled on food for patients who have difficulty swallowing tablets or capsules, for treatment of epilepsy. Qudexy XR was marketed as a branded drug in March 2014 and as a generic drug four months later. An earlier extended-release formulation (Trokendi XR) must be swallowed whole.

Trokendi XR is approved for initial monotherapy in patients ≥10 years old with partial-onset seizures or primary generalized tonic-clonic seizures and for adjunctive therapy in patients ≥6 years old with partial-onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome. Qudexy XR has been approved for the same indications, but the indication for adjunctive therapy has been extended to children ≥2 years old. Topiramate has been available for many years in immediate-release formulations (Topamax, and others) for the same indications for patients ≥2 years old. Trokendi XR and Qudexy XR both appear to be bioequivalent to immediate-release formulations of topiramate; whether they are bioequivalent to one another has not been established.

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Med Lett Drugs Ther. 2014 Dec 8;56(1457):e126 | Show Full IntroductionHide Full Introduction

A Responsive Neurostimulator Device (RNS System) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • July 21, 2014;  (Issue 1447)
The FDA has approved the use of a responsive neurostimulator device (RNS System – NeuroPace) for adjunctive treatment of adults with partial-onset seizures that are not controlled with ≥2...
The FDA has approved the use of a responsive neurostimulator device (RNS System – NeuroPace) for adjunctive treatment of adults with partial-onset seizures that are not controlled with ≥2 antiepileptic drugs and who have frequent and disabling seizures and no more than 2 epileptogenic foci.
Med Lett Drugs Ther. 2014 Jul 21;56(1447):63 | Show Full IntroductionHide Full Introduction

Eslicarbazepine Acetate (Aptiom) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • May 26, 2014;  (Issue 1443)
Eslicarbazepine acetate (Aptiom – Sunovion) has been approved by the FDA for adjunctive treatment of partial-onset seizures in adults. New drugs for epilepsy are often approved by the FDA initially only as...
Eslicarbazepine acetate (Aptiom – Sunovion) has been approved by the FDA for adjunctive treatment of partial-onset seizures in adults. New drugs for epilepsy are often approved by the FDA initially only as adjunctive treatment for partial seizures. Eslicarbazepine acetate is a prodrug of eslicarbazepine, which is the S-isomer of the active metabolite of oxcarbazepine. Oxcarbazepine itself is similar to carbamazepine. Both oxcarbazepine and carbamazepine are available generically.
Med Lett Drugs Ther. 2014 May 26;56(1443):42-3 | Show Full IntroductionHide Full Introduction

Perampanel (Fycompa) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • February 3, 2014;  (Issue 1435)
Perampanel (per am’ pa nel; Fycompa – Eisai), a first-in-class noncompetitive AMPA receptor antagonist, has been approved by the FDA for adjunctive treatment of partial-onset seizures in patients ≥12...
Perampanel (per am’ pa nel; Fycompa – Eisai), a first-in-class noncompetitive AMPA receptor antagonist, has been approved by the FDA for adjunctive treatment of partial-onset seizures in patients ≥12 years old. New drugs for epilepsy are often initially approved by the FDA as adjunctive treatment for partial seizures.
Med Lett Drugs Ther. 2014 Feb 3;56(1435):9-10 | Show Full IntroductionHide Full Introduction

Drugs for Migraine

   
The Medical Letter on Drugs and Therapeutics • December 1, 2013;  (Issue 136)
Treatment of migraine in the emergency department, which may involve use of intravenous drugs, is not discussed...
Treatment of migraine in the emergency department, which may involve use of intravenous drugs, is not discussed here.
Treat Guidel Med Lett. 2013 Dec;11(136):107-12 | Show Full IntroductionHide Full Introduction

In Brief: Ezogabine (Potiga) Toxicity

   
The Medical Letter on Drugs and Therapeutics • November 25, 2013;  (Issue 1430)
The FDA recently announced changes in the labeling of ezogabine (Potiga – GSK/Valeant) to warn about the risks of retinal abnormalities, possible vision loss, and bluish skin discoloration, all of which could...
The FDA recently announced changes in the labeling of ezogabine (Potiga – GSK/Valeant) to warn about the risks of retinal abnormalities, possible vision loss, and bluish skin discoloration, all of which could be permanent.1

Ezogabine was approved in 2011 for adjunctive treatment of partial-onset seizures in adults.2 The FDA first warned about these risks in April 2013.3 At that time, skin discoloration had developed in 38 of an estimated 605 patients (6.3%) who had taken the drug (most for ≥2 years) in various studies. Retinal pigment abnormalities were found in 11 of 36 patients who had eye examinations; some of these patients had impaired visual acuity, but baseline visual acuity assessments were not available.

The new label recommends limiting the use of ezogabine to patients who have not responded adequately to several alternative antiepileptic drugs. Patients taking the drug should have a baseline eye exam and follow-up exams every 6 months.

1. FDA Drug Safety Communication: FDA approves label changes for anti-seizure drug Potiga (ezogabine) describing risk of retinal abnormalities, potential vision loss, and skin discoloration. Available at www.fda.gov. Accessed November 18, 2013.

2. Ezogabine (Potiga) for epilepsy. Med Lett Drugs Ther 2012; 54:65.

3. FDA Drug Safety Communication: Anti-seizure drug Potiga (ezogabine) linked to retinal abnormalities and blue skin discoloration. Available at www.fda.gov. Accessed November 18, 2013.

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Med Lett Drugs Ther. 2013 Nov 25;55(1430):96 | Show Full IntroductionHide Full Introduction

Topiramate Extended-Release (Trokendi XR) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • October 28, 2013;  (Issue 1428)
The FDA has approved a once-daily extended-release (ER) formulation of the antiepileptic topiramate (Trokendi XR – Supernus) for initial monotherapy in patients ≥10 years old with partial onset seizures...
The FDA has approved a once-daily extended-release (ER) formulation of the antiepileptic topiramate (Trokendi XR – Supernus) for initial monotherapy in patients ≥10 years old with partial onset seizures or primary generalized tonic-clonic seizures and for adjunctive therapy in patients ≥6 years old with partial onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome. Topiramate has been available for many years as an immediate-release (IR) formulation (Topamax, and generics) for the same indications in patients ≥2 years old
Med Lett Drugs Ther. 2013 Oct 28;55(1428):87-8 | Show Full IntroductionHide Full Introduction

Drugs for Psychiatric Disorders

   
The Medical Letter on Drugs and Therapeutics • June 1, 2013;  (Issue 130)
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) can be used for many...
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) can be used for many of them as well. Electroconvulsive therapy (ECT) has a long history of efficacy and safety when drugs are ineffective or cannot be used.
Treat Guidel Med Lett. 2013 Jun;11(130):53-64 | Show Full IntroductionHide Full Introduction

Drugs for Pain

   
The Medical Letter on Drugs and Therapeutics • April 1, 2013;  (Issue 128)
Pain can be acute or chronic. The two major types of chronic pain are nociceptive pain and neuropathic pain. Nociceptive pain can be treated with nonopioid analgesics or opioids. Neuropathic pain is less...
Pain can be acute or chronic. The two major types of chronic pain are nociceptive pain and neuropathic pain. Nociceptive pain can be treated with nonopioid analgesics or opioids. Neuropathic pain is less responsive to opioids and is often treated with adjuvant drugs such as antidepressants and antiepileptics. Combining different types of analgesics may provide an additive analgesic effect without increasing adverse effects.
Treat Guidel Med Lett. 2013 Apr;11(128):31-42 | Show Full IntroductionHide Full Introduction

Ezogabine (Potiga) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • August 20, 2012;  (Issue 1397)
The FDA has approved ezogabine (ee-ZOE-ga-been; Potiga – GSK/Valeant) for oral adjunctive treatment of partial-onset seizures in adults. Ezogabine is available in Europe as retigabine...
The FDA has approved ezogabine (ee-ZOE-ga-been; Potiga – GSK/Valeant) for oral adjunctive treatment of partial-onset seizures in adults. Ezogabine is available in Europe as retigabine (Trobalt).
Med Lett Drugs Ther. 2012 Aug 20;54(1397):65-7 | Show Full IntroductionHide Full Introduction

Clobazam (Onfi) for Lennox-Gastaut Syndrome

   
The Medical Letter on Drugs and Therapeutics • March 5, 2012;  (Issue 1385)
Clobazam (Onfi – Lundbeck), an oral benzodiazepine, has been approved by the FDA for adjunctive treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in patients ≥2 years old. It has been...
Clobazam (Onfi – Lundbeck), an oral benzodiazepine, has been approved by the FDA for adjunctive treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in patients ≥2 years old. It has been available in Canada (Frisium) and other countries for years for treatment of anxiety and many types of epilepsy.
Med Lett Drugs Ther. 2012 Mar 5;54(1385):18-9 | Show Full IntroductionHide Full Introduction

Diet, Drugs and Surgery for Weight Loss

   
The Medical Letter on Drugs and Therapeutics • April 1, 2011;  (Issue 104)
...
Adults with a body mass index (BMI=kg/m2) of 25-<30 are considered overweight; those with a BMI of ≥30 are considered obese.
Treat Guidel Med Lett. 2011 Apr;9(104):17-22 | Show Full IntroductionHide Full Introduction

Drugs for Migraine

   
The Medical Letter on Drugs and Therapeutics • February 1, 2011;  (Issue 102)
Drugs for treatment of migraine are listed in Table 2 on page 9. Drugs for prevention of migraine are listed in Table 3 on page 10. Treatment of migraine in the emergency room, which may involve use of...
Drugs for treatment of migraine are listed in Table 2 on page 9. Drugs for prevention of migraine are listed in Table 3 on page 10. Treatment of migraine in the emergency room, which may involve use of intravenous drugs, is not included here.
Treat Guidel Med Lett. 2011 Feb;9(102):7-12 | Show Full IntroductionHide Full Introduction

Drugs for Depression and Bipolar Disorder

   
The Medical Letter on Drugs and Therapeutics • May 1, 2010;  (Issue 93)
Drugs are not the only treatment for mood disorders. Psychotherapy remains an important component in the management of these disorders, and electroconvulsive therapy (ECT) has a long history of efficacy and...
Drugs are not the only treatment for mood disorders. Psychotherapy remains an important component in the management of these disorders, and electroconvulsive therapy (ECT) has a long history of efficacy and safety when drugs are ineffective, poorly tolerated or cannot be used. Some drugs are recommended here for indications that have not been approved by the FDA.
Treat Guidel Med Lett. 2010 May;8(93):35-42 | Show Full IntroductionHide Full Introduction

Vigabatrin (Sabril) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • February 22, 2010;  (Issue 1332)
The FDA has approved vigabatrin (vye gá ba trin; Sabril – Lundbeck) for oral use as add-on therapy for complex partial seizures in adults who are refractory to several antiepileptic drugs and as monotherapy...
The FDA has approved vigabatrin (vye gá ba trin; Sabril – Lundbeck) for oral use as add-on therapy for complex partial seizures in adults who are refractory to several antiepileptic drugs and as monotherapy for infantile spasms. Vigabatrin has been available in other countries for many years. Because of its potential for retinal toxicity, it will be available in the US only through a restricted distribution program called SHARE (Support, Help and Resources for Epilepsy). Prescribers and pharmacists distributing the drug must register, and patients must undergo visual field testing.
Med Lett Drugs Ther. 2010 Feb 22;52(1332):14-6 | Show Full IntroductionHide Full Introduction

Generic Drugs Revisited

   
The Medical Letter on Drugs and Therapeutics • October 19, 2009;  (Issue 1323)
The equivalence of generic drugs to their brand-name precursors continues to be controversial. The last Medical Letter review of this subject (2002) concluded that well-documented therapeutic inequivalence...
The equivalence of generic drugs to their brand-name precursors continues to be controversial. The last Medical Letter review of this subject (2002) concluded that well-documented therapeutic inequivalence between brand-name and FDA-approved generic drugs had not been reported. Is that still true? New data have become available for some drugs.
Med Lett Drugs Ther. 2009 Oct 19;51(1323):81-2 | Show Full IntroductionHide Full Introduction

Lacosamide for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • June 29, 2009;  (Issue 1315)
The FDA has approved lacosamide (Vimpat - UCB Pharma) for oral or intravenous (IV) use as add-on therapy in adults with partial-onset...
The FDA has approved lacosamide (Vimpat - UCB Pharma) for oral or intravenous (IV) use as add-on therapy in adults with partial-onset seizures.
Med Lett Drugs Ther. 2009 Jun 29;51(1315):50-2 | Show Full IntroductionHide Full Introduction

Rufinamide (Banzel) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • March 9, 2009;  (Issue 1307)
Rufinamide (Banzel - Eisai), a triazole derivative structurally unrelated to other marketed antiepileptic drugs (AEDs), has been approved by the FDA for treatment of seizures associated with Lennox-Gastaut...
Rufinamide (Banzel - Eisai), a triazole derivative structurally unrelated to other marketed antiepileptic drugs (AEDs), has been approved by the FDA for treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in patients ≥4 years old.
Med Lett Drugs Ther. 2009 Mar 9;51(1307):18-20 | Show Full IntroductionHide Full Introduction

Drugs That May Cause Psychiatric Symptoms

   
The Medical Letter on Drugs and Therapeutics • December 15, 2008;  (Issue 1301)
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying illness, previously...
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.

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Med Lett Drugs Ther. 2008 Dec 15;50(1301):100-3 | Show Full IntroductionHide Full Introduction

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • June 1, 2008;  (Issue 70)
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases...
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases appear inadvisable because of adverse effects, most Medical Letter consultants generally prescribe at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs at the same time. Most antiepileptic drugs initially approved by the FDA only as adjunctive therapy for partial seizures may also be effective for other types of seizures and as monotherapy. Studies suggest that when used for the appropriate seizure type, antiepileptic drugs are roughly equivalent in efficacy. The choice of a drug is usually based on factors such as ease of use, adverse effects and cost.
Treat Guidel Med Lett. 2008 Jun;6(70):37-46 | Show Full IntroductionHide Full Introduction

Drugs for Migraine

   
The Medical Letter on Drugs and Therapeutics • March 1, 2008;  (Issue 67)
Some drugs for treatment of migraine attacks are listed in table 2 on page 18. Drugs for prevention of migraine are listed in table 3 on page 20. Treatment of migraine in the emergency room, which may involve...
Some drugs for treatment of migraine attacks are listed in table 2 on page 18. Drugs for prevention of migraine are listed in table 3 on page 20. Treatment of migraine in the emergency room, which may involve use of intravenous drugs, is not included here.
Treat Guidel Med Lett. 2008 Mar;6(67):17-22 | Show Full IntroductionHide Full Introduction

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • November 1, 2005;  (Issue 39)
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases...
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases appear inadvisable because of adverse effects, most Medical Letter consultants generally prescribe at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs at the same time. Most antiepileptic drugs initially approved by the FDA only as adjunctive therapy for partial seizures may also be effective for other types of seizures and as monotherapy.
Treat Guidel Med Lett. 2005 Nov;3(39):75-82 | Show Full IntroductionHide Full Introduction

Pregabalin (Lyrica) for Neuropathic Pain and Epilepsy

   
The Medical Letter on Drugs and Therapeutics • September 12, 2005;  (Issue 1217)
Pregabalin (Lyrica - Pfizer), a structural analog of gamma-aminobutyric acid (GABA) similar to gabapentin (Neurontin - Pfizer, and others), which recently became available generically, has been approved by the...
Pregabalin (Lyrica - Pfizer), a structural analog of gamma-aminobutyric acid (GABA) similar to gabapentin (Neurontin - Pfizer, and others), which recently became available generically, has been approved by the FDA for treatment of neuropathic pain associated with postherpetic neuralgia (PHN) and diabetic peripheral neuropathy (DPN), and for adjunctive treatment of partial onset seizures in adults with epilepsy.
Med Lett Drugs Ther. 2005 Sep 12;47(1217):75-6 | Show Full IntroductionHide Full Introduction

Topiramate (Topamax) for Prevention of Migraine

   
The Medical Letter on Drugs and Therapeutics • January 31, 2005;  (Issue 1201)
Patients with frequent, severe or disabling migraine headaches may benefit from taking a drug to prevent the attacks. Beta-blockers traditionally have been the prophylactic treatment of choice, but in recent...
Patients with frequent, severe or disabling migraine headaches may benefit from taking a drug to prevent the attacks. Beta-blockers traditionally have been the prophylactic treatment of choice, but in recent years some antiepileptic drugs such as valproate (Depakote, and others) and topiramate (Topamax) have also been used for this indication. Valproate was approved by the FDA for such use in 1996. Now topiramate has also been approved.
Med Lett Drugs Ther. 2005 Jan 31;47(1201):9-10 | Show Full IntroductionHide Full Introduction

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • May 1, 2003;  (Issue 9)
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases...
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases appear inadvisable because of adverse effects, most Medical Letter consultants generally prescribe at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs at the same time. Most antiepileptic drugs initially approved by the FDA only for adjunctive therapy are probably also effective as monotherapy. Many of the drugs used to treat epilepsy interact with each other (see table beginning on page 63) and with other drugs; for interactions with other drugs, see The Medical Letter Handbook of Adverse Drug Interactions, 2003. The treatment of status epilepticus is not included here.
Treat Guidel Med Lett. 2003 May;1(9):57-64 | Show Full IntroductionHide Full Introduction

Drugs That May Cause Psychiatric Symptoms

   
The Medical Letter on Drugs and Therapeutics • July 8, 2002;  (Issue 1134)
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously...
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.
Med Lett Drugs Ther. 2002 Jul 8;44(1134):59-62 | Show Full IntroductionHide Full Introduction

Drugs that may cause Cognitive Disorders in the Elderly

   
The Medical Letter on Drugs and Therapeutics • November 27, 2000;  (Issue 1093)
Older patients are especially susceptible to drug-induced cognitive impairment. They are more likely to be taking multiple drugs, to have higher blood levels of those drugs because of renal or hepatic...
Older patients are especially susceptible to drug-induced cognitive impairment. They are more likely to be taking multiple drugs, to have higher blood levels of those drugs because of renal or hepatic dysfunction, and to have pre-existing cognitive problems that make it difficult to detect the role of drugs causing new symptoms or making old ones worse.
Med Lett Drugs Ther. 2000 Nov 27;42(1093):111-2 | Show Full IntroductionHide Full Introduction