Practice advisory: The use of felbamate in the treatment of patients with intractable epilepsy

Abstract

Background/justification. Epilepsy is a common condition, affecting up to 1% of the population. Until recently, there were only a handful of effective medications to treat this condition, many of which produced unwanted side effects or were capable of producing serious adverse events in some people. Despite these drawbacks, from 1978, when valproate was introduced, until 1993, no new therapies emerged. In 1993, felbamate was approved by the Food and Drug Administration (FDA). At that time, it represented a significant advance for many patients with inadequately controlled seizures or with significant side effects for whom no options had been available. The substantial need for a new agent was evidenced by the fact that within 1 year, felbamate had been prescribed for 126,000 patients with epilepsy. 1 Many of these patients experienced complete seizure control for the first time. Others found that felbamate, which does not have the central nervous system depressant effect of many other agents, provided significant improvements in quality of life.