The pharmacokinetics and interactions of new antiepileptic drugs: An overview

In the past decade 10 new antiepileptic drugs (AEDs) have been introduced: felbamate, gabapentin, lamotrigine, levetiracetem, oxcarbazepine, pregabalin, tiagabine, topiramate, vigabatrin, and zonisamide. The pharmacokinetics (PK) of these new AEDs as well as their potential for drug interactions are reviewed in this article. In general, new AEDs have better PK profies and are less involved in drug interactions than the 4 established AEDs: phenobarbital, phenytoin, carbamazepine, and valproic acid. However, in spite of the large therapeutic arsenal of old and new AEDs, about 30% of epileptic patients are still not seizure-free, and thus, there is a substantial need to develop new AEDs.