Anticonvulsant Action and Long-term Effects of Gabapentin

Gabapentin (GBP), one of the newer antiepileptic drugs (AEDs), is a structural analogue of gamma-aminobutyric acid (GABA), initially approved for add-on treatment of partial seizures in patients 12 years and older and now widely used also in younger patients. Recent studies demonstrated its efficacy not only as adjunctive therapy but also as monotherapy for patients with partial seizures. GBP has an extremely low propensity to cause drug interactions and is well tolerated. The main adverse effects reported are behavioral disorders, such as hostility and mood swings. Recent data, showing increased GBP clearance in children, indicate the potential need for higher doses in young patients. The goal of seizure control in pediatric patients with epilepsy must be balanced against the long-term effects of AEDs on brain function and development. The anticonvulsant action and the long-term effects of GBP on learning, memory and behavior were investigated in studies on immature animals using models of temporal lobe epilepsy and status epilepticus (SE). These data demonstrated that acute administration of a single dose increases the seizure threshold at all ages studied, while chronic treatment following SE reduces spontaneous seizure frequency and cell damage and has no long-term adverse consequences on cognitive processes during development.