NEW-GENERATION ANTICONVULSANTS IN EPILEPSY: PRACTICAL SELECTION AND SAFETY MONITORING
Keywords:
epilepsy; antiseizure medicines (ASMs); new-generation anticonvulsants; brivaracetam; lacosamide; perampanel; cenobamate; monitoring.Abstract
Epilepsy is a chronic neurological disorder characterized by recurrent seizures. The main goals of treatment are to control seizures, minimize adverse effects, and improve patients' quality of life. In recent years, new-generation antiseizure medicines (ASMs) - brivaracetam, lacosamide, perampanel, cenobamate, cannabidiol, and fenfluramine - have stood out due to diversification of mechanisms and additional clinical options in some pharmacoresistant cases. This article, using an evidence-informed review approach, summarizes indications, efficacy signals, drug-drug interactions, and principles of safety monitoring for these agents. The findings suggest that new-generation ASMs are most often used as add-on therapy; optimal outcomes depend on patient-centered selection tailored to seizure type/syndrome, age and comorbidities, potential drug-drug interactions, and titration rate. In practice, targeted monitoring of treatment retention (persistence), cognitive and psychobehavioral effects, fall risk, and relevant laboratory indicators improves medication safety.
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