Is there any future for felbamate treatment?

Pol J Pharmacol. 2004 May-Jun;56(3):289-94.

Abstract

Felbamate (2-phenyl-1,3-propanediol dicarbamate), a representative of novel antiepileptic drugs (AESs), proved to have broad-spectrum anticonvulsive activity. Particularly beneficial efficacy was found against partial seizures and Lennox-Gastaut syndrome. Therefore, felbamate started to be indicated not only as an adjunctive antiepileptic drug but also in monotherapy. Unfortunately, it was also evidenced that the drug may induce aplastic anemia or hepatic failure. The former complication was frequently described in patients with previously diagnosed hematopoetic disturbances. Thirty-four cases of well-documented bone marrow suppression, occurred fatal in thirteen cases. Subsequently, felbamate's usage was essentially restricted and at present felbamate is not a first-line AED. However, excluding anemia-prone individuals, new possibilities may open for felbamate position in add-on therapy of drug-resistant epilepsy. Experimental studies provide a good theoretical basis for this kind of treatment.

Publication types

  • Review

MeSH terms

  • Anemia, Aplastic / chemically induced
  • Animals
  • Anticonvulsants* / adverse effects
  • Anticonvulsants* / pharmacokinetics
  • Anticonvulsants* / therapeutic use
  • Biological Availability
  • Disease Models, Animal
  • Epilepsy / drug therapy*
  • Felbamate
  • Half-Life
  • Humans
  • Phenylcarbamates
  • Propylene Glycols* / adverse effects
  • Propylene Glycols* / pharmacokinetics
  • Propylene Glycols* / therapeutic use
  • Randomized Controlled Trials as Topic

Substances

  • Anticonvulsants
  • Phenylcarbamates
  • Propylene Glycols
  • Felbamate