Anticonvulsants treatment-refractory

Topiramate, a sulfamate-substituted derivative of the monosaccharide cf-fructose, is an anticonvulsant agent (AHFS, 2000). The spectrum of topiramate s anticonvulsant activity resembles that of CBZ and phenytoin (Shank et ah, 2000). Topiramate has shown preliminary antimanic (McElroy et al., 2000) and possibly antidepressant efficacy in treatment-refractory, manic patients with BD type I (Calabrese et ah, 1998). 

Newer anticonvulsants such as levetiracetam and zonisamide have several published case reports or open trials showing efficacy in mania and treatment-refractory rapid cycling, but it is too early to predict whether they have a place in either acute or maintenance... 

Phenacemide, a substituted acetylurea derivative with anticonvulsant properties (500 mg p.o. t.i.d.), is indicated in the treatment of refractory, complex-partial, generalized tonic-clonic, absence, and atypical absence seizures. 

Valproic acid (Depakene or Depakote [divalproex sodium]) is a structurally unique anticonvulsant. It is used for the treatment of absence seizures, partial complex, and generalized seizure disorders and is a secondary agent for refractory status epilepticus. It is also commonly used for the prophylaxis and treatment of acute manic episodes and other affective disorders, migraine prophylaxis, and chronic pain syndromes. 

Gas Chromatographic Measurement of Plasma Levels of Sodium Valproate Tentative Therapeutic Range of a New Anticonvulsant in the Treatment of Refractory Epileptics Clin. Exp. Pharmacol. Physiol. 5(1) 67-73 (1978) CA 88 181302x... 

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