Have new antiseizure medications improved clinical care over the past 30 years?

摘要

The prevailing sentiment in discussions regarding advances in the treatment of resistant seizures is that we have made little progress over the past 30 years. Such conclusions are usually based on the fact that the proportion of patients who are rendered seizure free has not increased in decades. Moreover, numerous head-to-head studies have been done with old and new antiseizure medications and most trials have shown no difference in seizure freedom between the groups, albeit sometimes they do show superior tolerability of newer antiseizure medications.The explanation frequently given for this disappointing outcome is that the current animal models often select drugs that have a similar spectrum of activity. The remedy that is often suggested is to use new animal models that could select drugs with novel mechanisms.