Side Effects of felbamate: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Major Research Findings

Felbamate has shown promise in treating various seizure types, including partial seizures, Lennox-Gastaut syndrome, and infantile spasms, in patients with severe refractory epilepsy. 16 However, felbamate can cause serious side effects such as hepatotoxicity and aplastic anemia, so caution is required when using it. 19 Therefore, felbamate should only be used under the supervision of an experienced physician when other medications have not been effective. 1

Reasons for Side Effects

The side effects of felbamate are thought to be related to the drug's mechanism of action and metabolic pathways. Felbamate exerts its anticonvulsant effects by inhibiting the release of neurotransmitters or suppressing neuronal excitability. 18 However, these actions can also cause side effects. 6 In addition, felbamate is metabolized in the liver, and some metabolites may be toxic. 14 Therefore, liver function tests should be performed regularly during felbamate use. 19

Common Side Effects

Anorexia

Anorexia has been reported as a side effect of felbamate. 16 Anorexia can lead to weight loss and malnutrition, so caution is required. 22

Weight Loss

Weight loss has been reported as a side effect of felbamate. 16 Weight loss is thought to be related to anorexia or changes in metabolism. 22

Urinary Retention

Urinary retention has been reported as a side effect of felbamate. 16 Urinary retention is thought to be related to bladder dysfunction or difficulty urinating.

Somnolence

Somnolence has been reported as a side effect of felbamate. 16 Somnolence is thought to be related to the central nervous system depressant effects of felbamate. 26 Somnolence should be taken into consideration when performing tasks that require concentration and attention, such as driving or operating machinery.

Nervousness

Nervousness has been reported as a side effect of felbamate. 16 Nervousness can cause symptoms such as anxiety and insomnia. 21

Insomnia

Insomnia has been reported as a side effect of felbamate. 16 Insomnia is thought to be related to nervousness or sleep disorders. 21

Hepatotoxicity

Felbamate may rarely cause hepatotoxicity. 19 Hepatotoxicity can lead to liver inflammation and dysfunction. 6

Aplastic Anemia

Felbamate may rarely cause aplastic anemia. 19 Aplastic anemia is caused by bone marrow dysfunction, resulting in a decrease in the number of red blood cells, white blood cells, and platelets.

Countermeasures for Side Effects

Countermeasures for Anorexia and Weight Loss

If anorexia or weight loss is observed, it is necessary to consult a physician and consider appropriate measures such as dietary therapy or nutritional supplementation. 22

Countermeasures for Urinary Retention

If urinary retention is observed, it is necessary to consult a physician and consider appropriate treatments such as drug therapy to promote urination or other treatments.

Countermeasures for Somnolence

Somnolence may be improved by adjusting the dosage of felbamate. 26 Somnolence should be taken into consideration when performing tasks that require concentration and attention, such as driving or operating machinery.

Countermeasures for Nervousness and Insomnia

If nervousness or insomnia is observed, it is necessary to consult a physician and consider appropriate drug therapy such as anxiolytics or hypnotics. 21

Countermeasures for Hepatotoxicity

Regular liver function tests should be performed to prevent hepatotoxicity. 19 If liver abnormalities are found, felbamate use may need to be discontinued. 6

Countermeasures for Aplastic Anemia

If aplastic anemia is observed, felbamate use should be discontinued and appropriate treatments such as blood transfusion or bone marrow transplantation should be performed.

Comparison between Studies

Common Points of Studies

Many studies have shown that felbamate is effective in treating refractory epilepsy. 16 However, it is also commonly pointed out that felbamate can cause serious side effects such as hepatotoxicity and aplastic anemia. 19

Differences between Studies

The efficacy and frequency of side effects of felbamate may vary depending on the study. 16 This could be due to differences in the patient populations or study designs. 22

Cautions for Application in Real Life

Felbamate may be effective in treating severe refractory epilepsy, but it also carries a risk of serious side effects. 19 Therefore, felbamate should only be used under the supervision of an experienced physician when other medications have not been effective. 1 Regular liver function tests should be performed and efforts should be made to detect side effects early during felbamate use. 6

Limitations of Current Research

Research on felbamate is still insufficient. 20 In particular, data on long-term side effects and efficacy are lacking. 9

Future Research Directions

Future research on the long-term efficacy and side effects of felbamate is needed. 9 Research on the mechanism of action and metabolic pathways of felbamate is also needed. 18

Conclusion

Felbamate may be effective in treating severe refractory epilepsy, but it also carries a risk of serious side effects. 19 When using felbamate, it is necessary to fully understand the benefits and risks, and make a careful decision in consultation with a physician. 1

Keywords
Benefit Keywords
Epilepsy treatment
1
Improved seizure control
Minimal side effects
2
Improved seizure control
3
Control spasms
Normalize EEG
Outpatient treatment
4
Improved seizure control
5
Detect drug-induced cytotoxicity
6
Epilepsy treatment
7
Combination therapy
Epilepsy treatment
8
Improved catastrophic epilepsy
9
Improved seizure control
Reduced adverse effects
11
Treats childhood epilepsy
13
Epilepsy treatment
14
Seizure efficacy
15
Epilepsy treatment
16
Felbamate effective
17
Epilepsy treatment
18
Epilepsy treatment
Mood stabilization
Neuropathic pain
Seizure reduction
19
Improved epilepsy management
20
Seizure reduction
21
Seizure reduction
22
Lennox-Gastaut syndrome treatment
Partial seizures treatment
23
Better seizure control
New antiepileptic drugs
24
Good safety profile
Treat seizures
25
Improved learning
Reduced cognitive side effects
26
Risk Keywords
Aplastic anemia
Side effects
1
Seizure recurrence
Side effects
3
Hypertension
Serious infections
Side effects
Tolerance
Visual field loss
4
Side effects
5
Drug interaction
Side effects
7
Drug interactions
Side effects
Teratogenicity
8
Side effects
Visual field loss
9
lamotrigine side effects
10
Drug interactions
12
Side effects
14
Idiosyncratic reactions
Side effects
15
Anorexia
Insomnia
Nervousness
Somnolence
Urinary retention
Weight loss
16
Felbamate side effects
17
Aplastic anemia
Depression
Hepatic toxicity
Psychoses
Visual field deficit
19
Side effects
20
Abdominal discomfort
Acute psychosis
Anxiety
Difficulty sleeping
Orobuccal dyskinesias
Side effects
21
Anorexia
Behavioral changes
Sedation
22
Mild side effects
23
Drug interactions
Side effects
24
Mild side effects
25
Literature analysis of 26 papers
Positive Content
22
Neutral Content
3
Negative Content
1
Article Type
1
0
0
16
26
1.

Felbamate.

Author: LeppikI E

Epilepsy treatment
Aplastic anemia
Side effects

Felbamate (FBM) is a valuable antiepileptic drug for intractable epilepsy, but it has side effects like nausea and insomnia. While FBM can be beneficial for many patients, it should be used cautiously due to the risk of aplastic anemia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

2.

Treatment of epilepsy in the new millennium.

Author: PellockJ M

Improved seizure control
Minimal side effects

New antiepileptic drugs have been introduced in recent years that offer improved seizure control with minimal side effects. However, not all patients respond to these new drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

3.

Stopping drug therapy in epilepsy.

Author: LhatooS D, SanderJ W

Improved seizure control
Seizure recurrence
Side effects

The decision to stop antiepileptic drug (AED) therapy is often more difficult than the decision to start it.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

[West syndrome--new therapeutic approach].

Author: DjurićM, MarjanovićB, ZamurovićD

Control spasms
Normalize EEG
Outpatient treatment
Hypertension
Serious infections
Side effects
Tolerance
Visual field loss

West syndrome is a type of epilepsy in children that is difficult to treat. While benzodiazepines, ACTH, and corticosteroids can help, they have side effects. Vigabatrin is a newer treatment with fewer side effects, but it can cause vision problems. More research is needed to find the best treatment for each child.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Serbian

5.

[Advantages and disadvantages of new antiepileptic drugs].

Author: HerranzJ L

Improved seizure control
Side effects

This article discusses the advantages and disadvantages of newer antiepileptic drugs (vigabatrin, lamotrigine, gabapentin, and felbamate) in terms of their mechanisms of action, pharmacokinetic properties, therapeutic effects, and adverse events.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Spanish

6.

Development of a highly sensitive cytotoxicity assay system for CYP3A4-mediated metabolic activation.

Author: HosomiHiroko, FukamiTatsuki, IwamuraAtsushi, NakajimaMiki, YokoiTsuyoshi

Detect drug-induced cytotoxicity

This study constructed a cell-based system to evaluate the cytotoxicity of reactive metabolites produced by CYP3A4. The study found that HepG2 cells showed the highest CYP3A4 protein expression and activity among seven hepatoma cell lines. The cytotoxicity of 23 drugs was evaluated in AdCYP3A4-infected HepG2 cells, with 11 drugs showing significant decrease in cell viability.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Marketed new antiepileptic drugs: are they better than old-generation agents?

Author: PeruccaEmilio

Epilepsy treatment
Drug interaction
Side effects

This article discusses the impact of new-generation antiepileptic drugs on the management of epilepsy. While these drugs offer improved tolerability and efficacy, the need for more effective treatments and careful consideration of drug interactions remains.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

[Antiepileptics].

Author: OverwegJ

Combination therapy
Epilepsy treatment
Drug interactions
Side effects
Teratogenicity

Despite new antiepileptic drugs, phenytoin, carbamazepine, and valproate remain the preferred treatment for most forms of epilepsy. Newer drugs offer advantages like reduced enzyme induction and fewer side effects.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Dutch

9.

Pharmacologic treatment of the catastrophic epilepsies.

Author: ConryJoan A

Improved catastrophic epilepsy
Side effects
Visual field loss

Catastrophic epilepsies, such as infantile spasms, Lennox-Gastaut syndrome, and progressive myoclonic epilepsy, are difficult to treat. Traditional treatments, like adrenocorticotropic hormone, have serious side effects. Newer antiepileptic drugs, such as zonisamide, topiramate, and lamotrigine, show promise, but overall effectiveness remains limited. Further research is needed to develop more effective treatments.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Lamotrigine as a possible cause of QRS prolongation in a patient with known seizure disorder.

Author: HeroldThomas J S

lamotrigine side effects

This study reports a case of a 22-year-old woman who experienced lamotrigine toxicity following therapeutic use of the drug. The patient presented with nystagmus, ataxia, and widening of the QRS complex on ECG. Treatment with intravenous sodium bicarbonate resulted in QRS narrowing.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

[Antiepileptic drugs in North America].

Author: AkiyamaTomoyuki, OtsuboHiroshi

Improved seizure control
Reduced adverse effects

This review compares second-generation antiepileptic drugs (AEDs) and injectable AEDs available in North America and Japan. The second-generation AEDs have improved efficacy and safety profiles compared to older AEDs. Levetiracetam is considered to be the closest to being the ideal AED because of its broad-spectrum activity, favorable pharmacokinetic profile, and safety profile.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Japanese

12.

Treatment of epilepsy in the elderly.

Author: GareriP, GravinaT, FerreriG, De SarroG

Drug interactions

The management of epilepsy in the elderly involves many challenges, including age-related changes in pharmacokinetics and pharmacodynamics, concomitant diseases, polypharmacy, and drug compliance.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

New antiepileptic agents.

Author: NelsonLinda P, Savelli-CastilloIlse

Treats childhood epilepsy

This article provides an update for pediatric dentists on the efficacy and side effects of seven new antiepileptic drugs (AEDs) approved by the US Food and Drug Administration for the treatment of childhood epilepsy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

New antiepileptic drugs. Overcoming the limitations of traditional therapy.

Author: SirvenJ I, LiporaceJ D

Seizure efficacy
Idiosyncratic reactions
Side effects

This article provides an overview of new antiepileptic drugs, including felbamate, fosphenytoin, gabapentin, lamotrigine, and topiramate. It discusses their efficacy, side effects, and dosage considerations.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

The new drugs and the strategies to manage epilepsy.

Author: LimaJ M

Improved epilepsy management
Side effects

Lamotrigine and Topiramate are good candidates to replace VPA in the one drug strategy for epilepsy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

21.

Felbamate monotherapy: implications for antiepileptic drug development.

Author: TheodoreW H, AlbertP, StertzB, MalowB, KoD, WhiteS, FlaminiR, KetterT

Seizure reduction
Abdominal discomfort
Acute psychosis
Anxiety
Difficulty sleeping
Orobuccal dyskinesias
Side effects

This study investigated the effect of felbamate monotherapy on seizure rate in patients with partial and secondarily generalized seizures. Felbamate significantly reduced seizure frequency, but side effects were common, leading to premature discontinuation in some patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

23.

Felbamate overdose: a case report and discussion of a new antiepileptic drug.

Author: NagelT R, SchunkJ E

Lennox-Gastaut syndrome treatment
Partial seizures treatment
Mild side effects

The study reports a case of felbamate overdose in a teenage female patient who ingested eight times her maximum dose. The patient experienced only mild side effects. Felbamate's effectiveness, pharmacology, adverse effects, and drug interactions are discussed.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

Newer antiepileptic drugs: gabapentin, lamotrigine, felbamate, topiramate and fosphenytoin.

Author: CurryW J, KullingD L

Better seizure control
New antiepileptic drugs
Drug interactions
Side effects

Five new antiepileptic drugs have been approved, offering alternatives to traditional medications with side effects, but some of the new drugs have potential for significant adverse effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

25.

Advances in the pharmacotherapy of epilepsy.

Author: RamsayR E

Good safety profile
Treat seizures
Mild side effects

Three new antiepileptic drugs (AEDs), felbamate (FBM), gabapentin (GBP), and lamotrigine (LTG), have good safety profiles and are effective in the treatment of epilepsy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

26.

The effects of ethosuximide on aversive instrumental learning in adult rats.

Author: OrczykJohn J, GarraghtyPreston E

Improved learning
Reduced cognitive side effects

Ethosuximide (ETH) treatment did not impair cognitive performance in rats compared to controls in various learning tasks. This suggests ETH is a safe and effective antiepileptic drug for absence seizures, showing better results than valproic acid.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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