[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-42716-en":3,"doc-seo-42716-105":30,"detail-sidebar-cat-0-en-105":92},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":13,"seo_description":14,"update_tm":28,"read_time":29},42716,962075114765,"Quinn","https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd",7,"Healthcare","Recent Advances in Pharmacotherapy for Epilepsy","Epilepsy affects 70 million people worldwide and remains a major driver of morbidity and early mortality. While antiseizure medications have improved tolerability and ease of use, drug resistance persists in a large share of patients. Recent therapeutic development targets novel mechanisms and syndrome-specific care, including disease-modifying vigabatrin for tuberous sclerosis complex, fenfluramine for Dravet syndrome and Lennox–Gastaut syndrome, and cenobamate for adult focal seizures, alongside expanded rescue benzodiazepine formulations to reduce time to clinical effect.","REVIEW  \nUPRI RNIENTON Recent advances in pharmacotherapy for epilepsy  \nAmanda W. Pong, Kevin J. Xu and Pavel Klein  \nPurpose of review  \nEpilepsy affects 70 million people worldwide and is a significant cause of morbidity and early mortality. The mainstay of therapy is oral medications. Epilepsy drug development is escalating, driven by continued drug resistance in up to a third of epilepsy patients. Treatment development now focuses on discovery of novel mechanisms of action and syndrome-specific therapies  \nRecent findings  \nDifficult-to-treat epilepsy related to conditions including tuberous sclerosis complex (TSC), Lennox Gastaut syndrome (LGS) and Dravet syndrome (DS) have been the target of recent developments. Disease-modifying therapy for epilepsy related to TSC with vigabatrin at onset of first electroencephalographic epileptiform changes, rather than after first clinical seizure, has demonstrated strongly positive seizure and developmental outcomes. Fenfluramine, approved for DS and, more recently, LGS, has robust data supporting efficacy, safety/tolerability, as well as mortality, quality of life and cognitive function. Rescue therapy has expanded to include better tolerated benzodiazepines in the form of nasal midazolam and valium. Cenobamate, a first-in-class inactivator of the persistent voltage-gated sodium channel and approved for adult partial onset epilepsy, has exceptional efficacy and tolerability and will be expanded to children and to generalized onset epilepsy in adults.  \nSummary  \nThe repertoire of available and developmental therapies for epilepsy is rapidly expanding, and now includes disease-modifying vigabatrin in TSC and agents with extraordinary efficacy, fenfluramine and cenobamate.  \nKeywords  \nbriviracetam, cenobamate, clinical drug trial, Dravet syndrome, fenfluramine, Lennox Gastaut syndrome, nayzilam, rare genetic epilepsy, rescue medication, seizure clusters, tuberous sclerosis, valtoco, vigabatrin  \nINTRODUCTION  \nEpilepsy affects 􀀁 70 million people worldwide and is a significant cause of morbidity and early mortality. Mainstay therapy is antiseizure medications (ASMs) . During the last >35 years, a plethora of new ASMs has been developed. More than 20 new ASMs have been approved since 1990 . The new medications have improved side effect profile, ease of use and likely reduced severity of epilepsy. However, until recently there was little change in the proportion of patients whose epilepsy fails to respond to ASMs – drug resistant epilepsy (DRE) . This was 64% in 2014 vs. 63% in 1998, similar to 1980s when there were essentially only four ASMs. After failure of two appropriately prescribed ASMs, seizure freedom becomes unlikely [1] . This may be changing. In November 2019 and June 2020, the FDA approved two new ASMs with remarkable efficacy in DRE: cenobamate for focal seizures in adults and fenfluramine for seizures in Dravet syndrome (DS) . These two medications have the potential to  \nbring a paradigm shift in the treatment of drug resistant focal epilepsy and ofDS. In addition,2years ago, a third major breakthrough occurred with the first successfulprevention ofepilepsy, thegeneticepilepsy oftuberous sclerosis complex(TSC), usingvigabatrin, a drug commonly used for treatment of infantile spasms. Less revolutionarybut ofclinicalimportance, new formulations of intranasal benzodiazepines, midazolam(Nayzilam)and diazepam(Valtoco), were introduced in 2019 and 2020 for rescue treatment of acute repetitive seizures (cluster seizures) as an alternative to the rectal diazepam, Diastat. In this review,  \nMid-Atlantic Epilepsy and Sleep Center, Mid-Atlantic Neurological Institute, Bethesda, Maryland, USA  \nCorrespondence to Amanda W. Pong, MD, MSc, Mid-Atlantic Epilepsy and Sleep Center, Mid-Atlantic Neurological Institute, 6410 Rockledge Drive, \\#610, Bethesda, MD 20817, USA. Tel: +1 301 530 9744;  \ne-mail: [ponga@epilepsydc.com](ponga@epilepsydc.com)  \nCurr Opin Neurol 2023, 36:000–000  \nDO","cbCaiejlL0pjyt8m","https://ap.wps.com/l/cbCaiejlL0pjyt8m","pdf",1192618,5,1,9,"English","en",105,"# Purpose of review\n# Recent findings\n## Disease-modifying therapy\n## New syndrome-specific treatments\n## Expanded rescue therapy\n# Summary\n# Introduction\n# New medications\n## Cenobamate","[{\"question\":\"What is the main goal of current epilepsy pharmacotherapy development?\",\"answer\":\"Development increasingly focuses on discovering novel mechanisms of action and syndrome-specific therapies, particularly in drug-resistant epilepsy.\"},{\"question\":\"How does vigabatrin contribute to treatment in tuberous sclerosis complex?\",\"answer\":\"Vigabatrin used at the onset of early electroencephalographic epileptiform changes has demonstrated strong positive seizure and developmental outcomes, supporting disease-modifying effects.\"},{\"question\":\"Which newer drugs have been approved for specific epilepsy settings mentioned in the review?\",\"answer\":\"Cenobamate is approved for adult partial-onset/focal seizures, while fenfluramine is approved for Dravet syndrome and more recently for Lennox–Gastaut syndrome.\"}]",1783358116,23,{"code":4,"msg":31,"data":32},"ok",{"site_id":25,"language":24,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":87,"head_meta":89,"extra_data":91,"updated_unix":28},"recent-advances-in-pharmacotherapy-for-epilepsy","",{"@graph":36,"@context":86},[37,54,69],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,51],{"item":41,"name":42,"@type":43,"position":21},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":50},"https://docshare.wps.com/document/healthcare/",3,{"item":52,"name":13,"@type":43,"position":53},"https://docshare.wps.com/document/recent-advances-in-pharmacotherapy-for-epilepsy/42716/",4,{"url":52,"name":13,"@type":55,"author":56,"headline":13,"publisher":58,"fileFormat":61,"inLanguage":24,"description":14,"dateModified":62,"datePublished":63,"encodingFormat":61,"isAccessibleForFree":64,"interactionStatistic":65},"DigitalDocument",{"name":9,"@type":57},"Person",{"url":41,"name":59,"@type":60},"DocShare","Organization","application/pdf","2026-07-21","2026-07-06",true,{"@type":66,"interactionType":67,"userInteractionCount":20},"InteractionCounter",{"@type":68},"ViewAction",{"@type":70,"mainEntity":71},"FAQPage",[72,78,82],{"name":73,"@type":74,"acceptedAnswer":75},"What 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