Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Partial epilepsies: Choice of antiepileptic drugs in adults in the outpatient setting

Full Text:


The paper depicts the author's view on how a neurologist/epileptologist chooses an antiepileptic drug in his practice under present-day conditions. It considers possible clinical situations and therapeutic tactics in relation to the efficiency of performed therapy, as well as methods for switching to other antiepileptic drugs if the previous/first monotherapy is ineffective. The author gives main international and Russian guidelines in terms of the type of epileptic seizure/form of epilepsy/epilepsy syndrome. Despite its almost semicentennial history of effective clinical application, valproate is shown to be now a first-line choice drug for the therapy of undifferentiated, cryptogenic, and symptomatic partial epilepsies in patients of different age groups. The properties of valproate, such as efficacy against different types of seizures and forms of epilepsy, good tolerability, minimal aggravation risk, high monotherapy retention rates, various dosage forms, including the brand-name extendedrelease drug Depakine chrono or Depakine chronosphere and its intravenous formulation, favorable pharmacokinetic and pharmacodynamics profiles, make it indispensable at the present developmental stage of epileptology.

About the Author

P. N. Vlasov
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation
Department of Nervous System Diseases, Faculty of General Medicine


1. Карлов ВА. Эпилепсия у детей и взрослых, женщин и мужчин. Москва: Медицина; 2010. 720 с. [Karlov VA. Epilepsiya u detei i vzroslykh, zhenshchin i muzhchin [Epilepsy in children and adults, women and men]. Moscow: Medicina; 2010. 720 p.].

2. Карлов ВА, Овнатанов БС. Медиобазальные эпилептические очаги и абсансная активность на ЭЭГ. Журнал неврологии и психиатрии им. С.С. Корсакова. 1987;(6):805-11 [Karlov VA, Ovnatanov BS. Mediobasal epileptic foci of absence, and the activity on the EEG. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 1987;(6):805-11 (In Russ.)].

3. Зенков ЛР. Клиническая эпилептология. 2-е изд. Москва: МИА; 2010. 405 с. [Zenkov LR. Klinicheskaya epileptologiya [Clinical Epileptology]. 2nd ed. Moscow: MIA; 2010. 405 p.].

4. Holmes MD, Brown M, Tucker DM. Are generalized seizure truly generalized? Evidence of localized mesial frontal and frontopolar discharges in absence. Epilepsia. 2004;45:1568-79. doi: 10.1111/j.0013-9580.2004.23204.x

5. Авакян ГН. Отечественная эпилептология: проблемы и возможные пути развития. Эпилептология в системе нейронаук. Сборник материалов. Санкт-Петербург; 2015. С. 4-5 [Avakyan GN. Otechestvennaya epileptologiya: problemy i vozmozhnye puti razvitiya. Epileptologiya v sisteme neironauk. Sbornik materialov [Domestic Epileptology: problems and possible ways of development. Epileptology in neurosciences system. The collection of materials]. St. Petersburg; 2015. P. 4-5].

6. Власов ПН. Алгоритмы диагностики и терапии эпилепсии у взрослых в поликлинических условиях. Фарматека. 2006;(7):96-104 [Vlasov PN. Algorithms for the diagnosis and treatment of epilepsy in adults in outpatient conditions. Farmateka. 2006;(7):96-104 (In Russ.)].

7. Glauser T, Ben-Menachem E, Bourgeois B, et al. Updated ILAE evidence review of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes. Epilepsia. 2013;54(3):551-63. doi: 10.1111/epi.12074

8. St Louis EK, Gidal BE, Henry TR, et al. Conversions between monotherapies in epilepsy: Expert consensus. Epilepsy Behav. 2007;11:222-34. doi: 10.1016/j.yebeh. 2007.04.007

9. The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care. Issued: January 2012 last modified: December 2013. NICE clinical guideline 137

10. Vlasov PN, Petrukhin VA, Karlov VA, et al. Antiepileptic drug therapy during pregnancy and obstetric outcomes in Moscow region: comparing of 1998 and 2013 years. Epilepsia. 2014;55 Suppl. 2:130. doi: 10.1111/epi.12675

11. Ермоленко НА, Ермаков АЮ, Бучнева ИА. Эпилепсии с электрическим эпилептическим статусом во сне, особенности клинического течения и рациональные подходы терапии. Журнал невропатологии и психиатрии. 2011;(5):9-14 [Ermolenko NA, Ermakov AYu, Buchneva IA. Epilepsy with electrical status epilepticus during sleep, clinical course and treatment of rational approaches. Zhurnal Nevropatologii i Psikhiatrii. 2011;(5): 9-14 (In Russ.)].

12. Panayiotopoulos CP. A clinical guide to epileptic syndromes and their treatment. Revised 2nd ed. Springer; 2010. 654 p.

13. Агранович ОВ, Белопасов ВВ, Белоусова ЕД и др. Лечение фокальных эпилепсий: роль вальпроевой кислоты (депакина). Заключение экспертного совета. Журнал невропатологии и психиатрии. 2010;3(2):91-2 [Agranovich OV, Belopasov VV, Belousova ED, et al. Treatment of focal epilepsy: the role of valproate (Depakine). The conclusion of the expert council. Zhurnal Nevropatologii i Psikhiatrii. 2010;3(2):91-2 (In Russ.)].

14. Мухин КЮ, Пылаева ОА, Глухова ЛЮ и др. Основные принципы лечения эпилепсии. Алгоритм выбора антиэпилептических препаратов. Русский журнал детской неврологии. 2014;(4):2-11 [Mukhin KYu, Pylaeva OA, Glukhova LYu, et al. Basic principles of treatment of epilepsy. Algorithm selection of antiepileptic drugs. Russkii zhurnal detskoi nevrologii. 2014;(4):2-11 (In Russ.)].

For citation:

Vlasov P.N. Partial epilepsies: Choice of antiepileptic drugs in adults in the outpatient setting. Neurology, Neuropsychiatry, Psychosomatics. 2016;(1S):4-10. (In Russ.)

Views: 521

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)