Epileptic management

Tallis R, Boon P, Perucca E et al. (2002) Epilepsy in elderly people management issues. Epileptic Disord 4(Suppl 2) S33-S39... 

Several benzodiazepines are used in the management of epileptic seizures, although only a few are approved for the treatment of seizure disorders in the United States. Since the benzodiazepines share many properties, they will be discussed as a class individual members will be mentioned for specihc indications. 

The main drugs in this section are the barbiturates which can be considered as dry drink , and the withdrawal effects are very similar to the withdrawal from alcohol. Full-blown delirium tremens and epileptic fits can be observed and will need, usually, in-patient management and close supervision and sedation. 

It is an empirical decision whether to start with duloxetine or anti-epileptics for neuropathic pain management. Vigilant follow-up and patient education on drug-drug interactions are crucial to a successful launch of duloxetine. It is prudent to start with a low dose (20-30 mg) of duloxetine and titrate cautiously to balance the risk and benefit ratio. Duloxetine doses higher than 60 mg failed to provide any additional pain relief yet caused more adverse events and withdrawals according to previous clinical studies. 

Verma A, Kumar R, Kumar M. Ezogabine development and role in the management of epileptic seizures. Mini Rev Med Chem April 1, 2013 13(5) 697-705. 

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