Pharmakotherapie der Epilepsie

Zusammenfassung

Die medikamentöse Epilepsietherapie ist nach wie vor die Standardbehandlung, mit der bei der Mehrzahl der Patienten eine befriedigende Anfallskontrolle ohne Inkaufnahme unzumutbarer Nebenwirkungen erreicht wird. Durch neue Antikonvulsiva wurden die Therapiemöglichkeiten erweitert, Unterschiedliche Zulassungen, pharmakologische Profile, Generika und naturgemäß fehlende Langzeitverträglichkeitsdaten machen es aber nicht immer einfach und übersichtlich, welche Strategien derzeit empfehlenswert sind. Die hier vorgelegte Übersicht fasst den gegenwärtigen Standard zusammen und kommentiert die medikamentöse Erstauswahl, das Vorgehen bei Scheitern der ersten Therapie, das Phänomen der Pharmakoresistenz und besondere Aspekte wie das Konzept der rationalen Pharmakotherapie, den Umgang mit Generika und die Besonderheiten im Umgang mit Schwangerschaft.

Abstract

The adminstration of drugs is still the standard therapy for epilepsies. In the majority of patients, satisfying seizure control without intolerable adverse effects is achieved. As a consequence of new antiepileptic drugs therapeutic possibilities have improved. However, different labellings, varying pharmacological profiles, generics and apparently a lack of long-term data on tolerability sometimes make it difficult to decide and understand which strategy is best. This update review summarises the current standards and comments on the first drug choice, the strategy if the first therapy fails, the phenomenon of drug resistance, and special aspects such as the concept of so-called rational antiepileptic drug therapy, the appropriate use of generics and during pregnancy, respectively.

Schlüsselwörter

Epilepsie - Antikonvulsiva - Wirksamkeit - Verträglichkeit - Empfehlungen

Key words

epilepsy - anticonvulsants - serum concentration - recommendations

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