Treatment of Epilepsy: Background and Future Directions

Dito Anurogo, Taruna Ikrar


Epilepsy is a mystery even though it affects an estimated 50 million people worldwide. Its management is enigmatic and as such, is not curative, but rather aims to attain freedom from seizures without side-effects. However, an approach for the selection of the most effective drugs and doses for individual patients is lacking. Almost all of the antiepileptic drugs in current use are associated with adverse reactions, some of which are severe and life-threatening. A more comprehensive treatment strategy requires improved research on epilepsy. This is the key to developing a treatment plan focused on the individual needs of each patient. Pharmacogenetics can offer a novel line of attack in the treatment of epilepsy. The potential advantages of gene therapy in the management of epilepsy are manifold. It encompasses the principle of testing as to how genetic variation among individuals affects variation in drug response, efficacy, and potential adverse drug events. Pharmacogenomics is the investigation of relationships between patient genotype and responses to drug treatment. It holds the promise of selecting the right drug at the right dose for the right person. A conceptual framework that outlines the pharmacogenetic and pharmacogenomic aspects of epilepsy presented here. Future directions for research and the application of these technologies to the clinical practice of individualising treatment for epilepsy are also discussed. A combination of research strategies and prudent policies from government may lead to a better understanding of treatment effects and futuristic but realistic management in epilepsy.


Epilepsy; Etiology; Neurogenetics; Pharmacogenomics; Pharmacogenetics

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