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P A R T 4
Drugs acting on the central and peripheral nervous systems
TABLE 23.3
DRUGS IN FOCUS Drugs for treating partial seizures
Drug name
Dosage/route
Usual indications
carbamazepine
(Tegretol)
Adult: 800–1200 mg/day PO in divided doses
q 6–8 hours
Paediatric (>12 years): adult doses, do not
exceed 1000 mg/day
Paediatric (6–12 years): 20–30 mg/kg per day
PO in divided doses t.d.s. to q.i.d.
Paediatric (<6 years): 35 mg/kg per day PO
Drug of choice for treatment of partial
seizures and tonic–clonic seizures;
treatment of trigeminal neuralgia, bipolar
disorder
gabapentin (Neurontin)
Adult: 900–1800 mg/day PO in divided doses
t.d.s.
Paediatric (3–12 years): 10–15 mg/kg per day
PO in divided doses
Used as adjunct in treating partial seizures;
treatment of postherpetic pain in adults
and children ages 3–12 years of age; has
orphan drug status for the treatment of
amyotrophic lateral sclerosis; treatment
of pain, migraines, bipolar disorders,
tremors of multiple sclerosis and nerve-
generated pain states
lacosamide (Vimpat)
Adults : 50–200 mg PO or IV b.d.
Paediatric (>16 years): 50–200 mg PO or IV
b.d.
Used as adjunct in treating partial seizures
with or without secondary generalisation
lamotrigine (Lamictal)
Adult: 300–500 mg/day PO in divided doses
b.d.
Paediatric (2–12 years): 1–5 mg/kg per day PO
in divided doses b.d.
Paediatric (>12 years): 100–400 mg/day PO in
divided doses b.d.
Used as adjunct or for monotherapy in
treating partial seizures and in treatment
of seizures associated with Lennox–
Gastaut syndrome in adults and children
≥2 years of age; long-term treatment of
bipolar disorders
levetiracetam (Keppra)
Adult: 500 mg PO b.d. up to 3000 mg/day
Paediatric (4–16 years): 10 mg/kg PO b.d. to a
maximum of 1500–3000 mg/day
Newer drug approved for adjunctive
treatment of partial seizures in adults
and children ≥4 years of age; in 2007,
it was also approved for the treatment
of primary generalised tonic–clonic
seizures in adults and treatment of
children ≥6 years of age with idiopathic
generalised epilepsy; being studied
for use in absence seizures, myoclonic
seizures and drug-resistant seizures of
multiple types
oxcarbazepine (Trileptal)
Adult: 600 mg PO b.d.
Paediatric (4–16 years): 8–10 mg/kg per day PO
Used for monotherapy or adjunctive
therapy in treatment of partial seizures
in adults and children 4–16 years of
age; also being studied as an alternative
treatment of bipolar disease
pregabalin (Lyrica)
150–600 mg/day PO in divided doses
Neuropathic pain: 100 mg PO t.d.s.
Postherpetic neuralgia: 75–150 mg PO t.d.s.
Used for adjunctive treatment of adults
with partial-onset seizures; management
of neuropathic pain associated with
diabetic peripheral neuropathy and
postherpetic neuralgia; fibromyalgia
tiagabine (Gabitril)
Adults and paediatrics (>12 years): Initially
7.5–15 mg/day PO in three divided doses,
up to 30–50 mg/day PO
Used as adjunct in treating partial seizures
in and in children 12–18 years of age
topiramate (Topamax)
Adults 500–1000 mg PO daily in two divided
doses
Paediatric (2–16 years): 3–6 mg/kg per day PO
in two divided doses
Used as adjunct in treating partial seizures
in adults and children 2–16 years of age;
also approved for treatment of tonic–
clonic seizures, for prevention of migraine
headaches, and as adjunct therapy
in Lennox–Gastaut syndrome; being
studied for use in cluster headaches,
infantile spasms, alcohol dependence,
bulimia nervosa and weight loss
