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Anticonvulsant Agents: Beginning and Duration of Therapy, Withdrawal, and Resistance – Children

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NeuroPsychopharmacotherapy

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Abstract

Epilepsy is a common neurological disorder with more than half of the cases starting in childhood. Most of these patients require at least transient and some lifelong medication with antiepileptic drugs. Some special consideration should to be made when treating children with anticonvulsant drugs compared to adults as the potential negative impact of the medication on the developing brain, different pharmacokinetics and pharmacodynamics, and a poor total number of clinical trials resulting only in low evidence levels of efficacy for the majority of drugs. Furthermore, approval of a certain anticonvulsant drug by the national authorities (i.e., FDA in the USA and the EMA in Europe) may differ from country to country and is usually less open to children than to adults. Thus, physicians treating patients with epilepsy are commonly faced with off-label use of AEDs especially in very young children. In the present chapter, starting and duration anticonvulsant therapy as well as withdrawal and resistance to antiepileptic drugs in children with epilepsy will be addressed.

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Abbreviations

AED:

Antiepileptic drug

ANS:

Anterior thalamic stimulation

BR:

Potassium bromide

CBD:

Cannabidiol

CBZ:

Carbamazepine

CLB:

Clobazam

ESL:

Eslicarbazepine

ESM:

Ethosuximide

GLUT-1:

Glucose transporter 1

LCM:

Lacosamide

LEV:

Levetiracetam

LTG:

Lamotrigine

OXC:

Oxcarbazepine

PER:

Perampanel

PHT:

Phenytoin

STM:

Sultiame

TPM:

Topiramate

TSC:

Tuberous sclerosis complex

VGB:

Vigabatrin

VNS:

Vagal nerve stimulation

VPA:

Valproic acid

ZNS:

Zonisamide

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Authors and Affiliations

  1. Comprehensive Epilepsy Program for Children, Division of Paediatric Neurology, Developmental Medicine and Social Paediatrics, Department of Paediatrics, University of Munich, Munich, Germany

    Ingo Borggraefe

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  1. Ingo Borggraefe
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Correspondence to Ingo Borggraefe .

Editor information

Editors and Affiliations

  1. Dept Psychiatry , Psychosomatics & Psychotherapy, University of Würzburg, Medical School Clinical Neurochemistry, Würzburg, Germany

    Peter Riederer

  2. Inst für Psychologische Medizin, Haag, Bayern, Germany

    Gerd Laux

  3. Department of Psychiatry, University of Toronto Department of Psychiatry, Toronto, ON, Canada

    Benoit Mulsant

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Fujita Health University School Medicine, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

Section Editor information

  1. Beta Neurology – Competence Center for Epilepsy, Beta Klinik GmbH, Bonn, Germany

    Christian E. Elger FRCP

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Borggraefe, I. (2020). Anticonvulsant Agents: Beginning and Duration of Therapy, Withdrawal, and Resistance – Children. In: Riederer, P., Laux, G., Mulsant, B., Le, W., Nagatsu, T. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_371-1

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  • DOI: https://doi.org/10.1007/978-3-319-56015-1_371-1

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