MEDIX, God. 20 Br. 111  •  Pregledni članak  •  Neurologija HR ENG

Epilepsija – najnovije mogućnosti medikamentne terapijeEpilepsy – new possibilities of pharmacological therapy

Sanja Hajnšek, Željka Petelin Gadže

Epilepsija je jedna od najčešćih neuroloških bolesti, koja je zbog svojih karakteristika značajan medicinski i socijalni problem, a u najvećeg broja bolesnika može se zadovoljavajuće liječiti. Preporuke za uspješno liječenje jesu: što bolje definirati klinički fenotip ili epileptični sindrom, što ranije uključiti pravilnu antiepileptičnu terapiju u optimalnoj dozi te posebnu pozornost posvetiti specifičnoj populaciji koju čine žene u generativnoj dobi i bolesnici starije dobne skupine, s obzirom na fiziološke specifičnosti, komorbiditet, kao i promijenjen mehanizam djelovanja antiepileptika te koadministriranu terapiju i moguće interakcije s antiepilepticima. Poštujući navedene preporuke u oko 70–80% bolesnika postiže se remisija bolesti. Preostali, tzv. farmakorezistentni bolesnici, unatoč redovitom uzimanju terapije imaju i dalje epileptične napadaje te su kandidati za neurokirurško liječenje. Noviji antiepileptični lijekovi doveli su do više terapijskih opcija, no nisu bitno smanjili učestalost bolesnika s farmakorezistentnom epilepsijom. 

Ključne riječi:
antiepileptici, indikacije, interakcije; epilepsija; specifična populacija

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Epilepsy is one of the most common neurological diseases. Due to its characteristics it is a serious medical and social problem, but in the majority of patients can be successfully treated. Recommendations for successful treatment are: defining the clinical phenotype or epileptic syndrome as good as possible, starting the proper antiepileptic therapy with optimal dosage as early as possible, and to pay special attention to a specific population of women of childbearing age and patients in older age groups, due to the physiological specificity, comorbidities as well as altered mechanism of action of antiepileptic drugs, and co-administered therapy and possible interactions with antiepileptic drugs. Following these recommendations approximately 70-80% of patients’ remission is achieved. The remaining so-called pharmacoresistant patients continue to have seizures despite their regular therapy and are candidates for neurosurgical treatment. The newer antiepileptic drugs have led to more treatment options, but they have not significantly reduced the incidence of patients with refractory epilepsy. 

Key words:
antiepileptics, indications, interaction; epilepsy; specific populations