Novel Molecular Targets for Drug-Treatment of Epilepsy

Abstract

Nowadays several antiepileptic drugs (AEDs) are available for the treatment of patients with epilepsy. Nevertheless, up to 30 % of patients continue to present recurrent seizures. So, the challenge for new more efficacious and better tolerated drugs is continuing. Advances in understanding of pathophysiology of epilepsy and in the physiology of ion channels and other molecular targets provide opportunities to create new and improved AEDs. Potentially interesting molecular targets include KCNQ-type K+ channels, SV2A synaptic vesicle protein, ionotropic and metabotropic glutamate receptors. The pipeline for the development of new AEDs with novel mechanisms of action is narrowing with only a few interesting compounds on the immediate horizon. In fact, only perampanel (modulates AMPA mediated neurotransmission) and brivaracetam (binds to SV2A protein and sodium channel) are likely to reach the market-place in the next 3 years. Eslicarbazepine has approved in the last year as add-on treatment for partial onset seizures. This chapter reviews the available information on various classes of molecules that are in the pipeline for the treatment of epilepsy.