felbamate / Generic mfg. - LARVOL DELTA

Epilepsy with myoclonic-atonic seizures: a comprehensive review with emphasis on current and emerging pharmacotherapies. (PubMed, Expert Rev Neurother) - "Treatment is reviewed hierarchically, from valproate, clobazam, levetiracetam and ethosuximide as commonly used first- and second-line agents to the ketogenic diet, cannabidiol, felbamate, and sulthiame for drug-resistant disease. Although approximately two-thirds of patients with EMAtS achieve seizure remission, a substantial minority experience drug-resistant seizure, intellectual disability, and behavioral comorbidities, underscoring the importance of timely diagnosis, appropriate pharmacotherapy, and early consideration of the ketogenic diet in drug-resistant cases. As precision therapeutics advance, syndrome-based care will increasingly be complemented by treatments tailored to the specific genetic etiology."

Journal • Review • CNS Disorders • Developmental Disorders • Epilepsy • Mental Retardation • CHD2 • SLC2A1 • XBP1

Potential Role of CYP3A4 in Determining In Vivo Exposure to Cannabidiol (CBD) and its Active Metabolite 7-OH-CBD: Evidence from an In Vitro Study. (PubMed, Eur J Drug Metab Pharmacokinet) - "ASMs with CYP3A4-inhibitory potential may alter systemic exposure to both CBD and its active metabolite, 7-OH-CBD, as demonstrated in vitro. However, co-administration of CBD with CYP3A4-substrate ASMs or CYP2C19 inhibitors is predicted to result in only modest increases in CBD exposure."

Journal • Preclinical • CNS Disorders • Epilepsy • CYP2C19 • CYP2C9 • CYP3A4

Expanding the electroclinical spectrum of TANC2-related disorders: Lennox-Gastaut syndrome and related developmental epileptic phenotypes. (PubMed, Epilepsia Open) - "TANC2 is a gene involved in brain development and synaptic function. Changes in this gene have been linked to neurodevelopmental disorders, autism, intellectual disability, and epilepsy. We describe three individuals with previously unreported truncating TANC2 variants and different epilepsy phenotypes, including one patient fulfilling criteria for Lennox-Gastaut syndrome (LGS) and another with LGS-like features. Although seizures were initially difficult to treat in some cases, seizure control was eventually achieved. These findings expand the known clinical spectrum of TANC2-related disorders and suggest that selected patients may have a more favorable seizure course than expected."

Journal • Autism Spectrum Disorder • CNS Disorders • Developmental Disorders • Epilepsy • Genetic Disorders • Mental Retardation • Psychiatry

Multisystem Complications in Spinal Muscular Atrophy Type III: Chronic Respiratory Failure and Intractable Epilepsy. (PubMed, Cureus) - "Orthopedic complications included neuromuscular scoliosis requiring spinal fusion. This case underscores how SMA type III evolves into a multisystem disorder with cumulative respiratory, neurologic, and orthopedic morbidity, highlighting the need for vigilant longitudinal surveillance, proactive respiratory support, individualized seizure management, and coordinated interdisciplinary care."

Journal • CNS Disorders • Cough • Critical care • Epilepsy • Genetic Disorders • Hematological Disorders • Infectious Disease • Movement Disorders • Muscular Atrophy • Orthopedics • Pulmonary Disease • Rare Diseases • Respiratory Diseases • SMA4 • SMN1 • SMN2

SCN9A mutations may contribute to medically refractory epilepsy (AAN 2026) - "His seizures were refractory to brivaracetam, lacosamide, zonisamide, oxcarbazepine. He is currently on clobazam, felbamate and valproic acid, with seizures occurring every other week...He is currently on zonisamide, levetiracetam, rufinamide, cannabidiol, and clobazam and continues to have seizures every few days...These specific gene mutations have not been well characterized in literature; thus, these cases may provide insight into mutations that may be pathogenic. Further research is necessary to determine exactly what role these variants play in epilepsy."

CNS Disorders • Epilepsy • NAV1 • SCN8A

Influence of hepatic steatosis on antiseizure drug metabolism: in vitro evidence from differentiated HepaRG cells. (PubMed, Toxicol Lett) - "Hepatic steatosis selectively alters the metabolism of carbamazepine and levetiracetam in vitro without enhancing short-term cellular toxicity. These findings raise concerns about possible modifications in drug exposure, efficacy and tolerability in patients with MASLD, and underscore the need for further in vivo and clinical studies."

Journal • Preclinical • CNS Disorders • Epilepsy • Genetic Disorders • Hepatology • Metabolic Disorders • Metabolic Dysfunction-Associated Steatotic Liver Disease • Obesity • CYP3A4

The Discovery of Cenobamate: A Drug with High Efficacy in Drug-Resistant Epilepsy. (PubMed, CNS Drugs) - "Herein, we describe the chemocentric and phenotypic screening strategy employed by one of us (Yong Moon Choi) while at SK Biopharmaceuticals and how cenobamate was developed by optimizing earlier alkyl-carbamates such as carisbamate and felbamate...Cenobamate was found to display potent broad-spectrum activity in diverse disease-relevant rodent models, including maximal electroshock, pentylenetetrazole, kindling, and lithium-pilocarpine-induced status epilepticus...The dual mechanisms of cenobamate may serve as a blueprint for designing ASMs with synergistic actions. Approval of cenobamate represents a paradigm shift in epilepsy treatment and offers a promising framework for discovering more effective therapies for drug-resistant epilepsy."

Journal • Review • CNS Disorders • Epilepsy

Efficacy and tolerability of felbamate in adults with severe intellectual and developmental disabilities and drug-resistant epilepsy: A single-center evaluation. (PubMed, Seizure) - "Felbamate may provide sustained clinical benefit in adults with severe IDD and refractory epilepsy when used under structured clinical and laboratory monitoring."

Journal • Anorexia • Aplastic Anemia • CNS Disorders • Developmental Disorders • Epilepsy • Fatigue • Hematological Disorders • Hepatology • Liver Failure • Psychiatry • Sleep Disorder

Antiseizure Drug-Associated Drug Reaction with Eosinophilia and Systemic Symptoms in a U.S. Single-center Cohort (AAD 2026) - "Culprit drugs included lamotrigine (35.3%), carbamazepine (32.4%), phenytoin (11.8%), levetiracetam (8.8%), oxcarbazepine (5.9%), and single cases (2.9% each) of lacosamide, felbamate, quetiapine, pentobarbital, valproate, and gabapentin. Antiseizure drug–induced DRESS causes heterogeneous rash, high morbidity and mortality, with liver commonly affected. Symptoms typically appeared after ~4 weeks."

Clinical • CNS Disorders • Dermatitis • Eosinophilia • Epilepsy • Gastrointestinal Disorder • Hematological Disorders • Immunology

Psychiatric and behavioural side effects of antiseizure medications in epilepsy. (PubMed, J Neurol) - "PBSEs can often be anticipated, mitigated, and frequently reversed. A risk-stratified prescribing strategy-monotherapy first, enzyme-neutral or mood-friendly medications for vulnerable patients, folate supplementation for inducers, and early switch from offending agents-can safeguard mental health without compromising seizure control."

Adverse events • Journal • Review • CNS Disorders • Developmental Disorders • Epilepsy • Mental Retardation • Psychiatry

Felbamate and Ganaxolone for Improving Outcome in Pediatric Febrile Infection-Related Epilepsy Syndrome (FIRES) (AES 2025) - "1) Felbamate was trialed during acute phase of illness and continued as maintenance regimen 2) Ganaxalone was trialed off label for two severe cases of FIRES. Both medication trials correlated with lower mortality, decreased ICU duration compared to data described in prior NORSE/FIRES literature, and exhibit no recurrence of seizures to date. This institutional experience suggests that utilizing Ganaxalone and Felbamate during acute hospitalization and continuing outpatient may facilitate improved outcomes as defined by seizure control, mortality, and relatively shorter ICU duration."

Clinical • Late-breaking abstract • CNS Disorders • Epilepsy • Immunology • Infectious Disease • Pediatrics • IL2 • IL6

Rare Case Study of Unverricht-Lundborg Disease in Two Siblings: Insight to Genetics and Phenotypic Expression (AES 2025) - "The current regimen includes clonazepam, valproic acid, felbamate, brivaracetam, and cannabidiol. The younger sibling also requires zonisamide... In cases of stimulus-induced myoclonus, progressive GTCs, and ataxia with cognitive decline, clinicians should consider Progressive Myoclonic Epilepsy type 1 (ULD) and confirm with genetic testing. Antiepileptic polytherapy is required. While stimulus-sensitive myoclonic jerks can be resistant, GTCs may respond favorably to treatment."

Case study • Clinical • Ataxia • CNS Disorders • Depression • Epilepsy • Gastrointestinal Disorder • Movement Disorders • Psychiatry

Felbamate Treatment Persistence in Children with Epilepsy (AES 2025) - "More than 50% of children with epilepsy who are treated with FBM will continue to take the treatment for a year or more without additional treatments added or treatment discontinuation. FBM is more often discontinued for lack efficacy than lack of tolerability or safety. In this cohort, FBM use was safe."

Clinical • CNS Disorders • Epilepsy • Hematological Disorders • Leukopenia

Vagus Nerve Stimulator Placement in a 7-Month-Old with GABRB3 Pathogenic Variant: A Case Report (AES 2025) - "Despite trials of multiple anti-seizure medications (Levetiracetam, Phenobarbital, Felbamate, Clobazam, and Lacosamide) and initiation of the ketogenic diet, seizures persisted ( >20/day) and were accompanied by developmental regression. This case illustrates the potential efficacy and tolerability of VNS in an infant under one year of age with drug-resistant epilepsy due to a GABRB3 pathogenic variant. The patient eventually became seizure free after VNS modification to rapid cycling and weaning all seizure medication. Although data remains sparse for this population, both the age and genetic variant, our findings support the consideration of VNS as an early intervention in infants under 1 year of age with medically refractory epilepsy."

Case report • Clinical • CNS Disorders • Epilepsy

Centromedian Thalamic DBS Achieves Substantial Seizure Control in an Ultra-Refractory Lennox-Gastaut Syndrome Unresponsive to VNS and Polytherapy (AES 2025) - "Failed antiseizure medications (ASMs) included divalproex sodium, felbamate, clobazam, and topiramate. At the time of DBS evaluation, she was on cannabidiol, cenobamate, and lacosamide... This case demonstrates a promising early response and sustained 80% reduction in seizure frequency over six months, highlighting CM-DBS as a viable salvage option for ultra-refractory LGS."

Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Developmental Disorders • Epilepsy • Mental Retardation

EPIPOP: Population Pharmacokinetics of Antiepileptic in Pediatrics (clinicaltrials.gov) - P=N/A | N=753 | Completed | Sponsor: Assistance Publique - Hôpitaux de Paris | Recruiting ➔ Completed

Trial completion • CNS Disorders • Epilepsy • Pediatrics

FROM FELBAMATE TO CARBAMAZEPINE: CLINICAL CONSEQUENCES OF UNINTENTIONAL ANTIEPILEPTIC SUBSTITUTION IN REFRACTORY EPILEPSY (WCN 2025) - "This case underscores the dangers of unsupervised AED substitutions in refractory epilepsy. Carbamazepine may provoke serious neurological and hematologic effects, even at normal levels, particularly in metabolically vulnerable individuals. Safe management of refractory epilepsy requires precise drug continuity, provider oversight, and international care coordination."

Clinical • Ataxia • CNS Disorders • Epilepsy • Movement Disorders

From Felbamate to Carbamazepine: Clinical Consequences of Unintentional Antiepileptic Substitution in Refractory Epilepsy. (PubMed, Cureus) - "Inadvertent substitution of antiepileptic medications in patients with refractory epilepsy can lead to serious multisystem complications. Vigilant medication management and multidisciplinary care are essential to prevent adverse outcomes."

Journal • Ataxia • CNS Disorders • Epilepsy • Hematological Disorders • Movement Disorders

Current evidence for the role of rapid-acting antidepressants (RAAD) in bipolar depression? A perspective and plan for action. (PubMed, Biol Psychiatry) - "The following RAAD substance classes have been or are currently being investigated as possible treatments for bipolar depression: NMDA antagonists and indirect AMPA agonists (ketamine, esketamine, riluzole, felbamate), GABAA (gamma-aminobutyric acid A) activators or positive allosteric modulators (zuranolone, pregnenolone, PEA), psychedelics (psilocybin, 5-MeO-DMT), muscarine receptor antagonists (scopolamine), and kappa opioid receptor antagonists (navacaprant). Recent research into RAADs demonstrates the growing field of novel mechanisms of action in the pharmacological treatment of bipolar depression. However, there is an urgent need for well-controlled clinical studies on RAADs in bipolar depression to expand treatment options and improve outcomes for millions of affected individuals worldwide."

Journal • Review • Bipolar Disorder • CNS Disorders • Depression • Mood Disorders • Psychiatry

Drug-resistant Epilepsy: Which Drugs are Substrates of P-glycoprotein and Which are Not? (PubMed, Curr Neuropharmacol) - "among the anticrisis medications, the following are likely substrates of P-glycoprotein: Phenytoin, Phenobarbital, Oxcarbazepine, Lamotrigine, Topiramate, and Lacosamide (less evidence). The following are probably not substrates: Brivaracetam, Zonisamide, Valproic acid, Perampanel, Gabapentin, and Vigabatrin. We have not obtained enough information about: Carbamazepine, Eslicarbazepine, Levetiracetam, Tiagabine, Felbamate, Pregabalin, Rufinamide, Ezogabine, and Retigabine."

Journal • CNS Disorders • Epilepsy

Current and emerging pharmacotherapies in lennox-Gastaut syndrome. (PubMed, Expert Opin Pharmacother) - "This review examines FDA-approved medications for LGS (clonazepam, felbamate, lamotrigine, topiramate, rufinamide, clobazam, cannabidiol, and fenfluramine), commonly used off-label antiseizure medications, emerging treatments in clinical trials, and precision therapeutics targeting etiology-specific mechanisms. Future progress depends on improved natural history studies, standardized data collection, advanced preclinical models, innovative trial designs, and addressing healthcare inequities. While emerging precision therapies targeting genetic causes show promise, the field urgently needs better strategies to optimize existing treatments while developing disease-modifying approaches that address both seizures and non-seizure outcomes."

Journal • Review • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Epilepsy • Gene Therapies

Seizure-type-specific treatment responses in Lennox-Gastaut Syndrome: A comprehensive review of pharmacological, neuromodulatory, dietary, and surgical therapies. (PubMed, Epilepsy Behav) - "Generalized tonic-clonic seizures (GTCS) show favorable responses to antiseizure medications (ASMs) such as felbamate, lamotrigine, topiramate, fenfluramine, lacosamide, and perampanel. Myoclonic seizures tend to respond better to clonazepam, topiramate, zonisamide, brivaracetam, and perampanel, but may show limited responsiveness to neuromodulation and CC. Atypical absence seizures may respond to valproate, topiramate, and rufinamide, but show poor responses to brivaracetam and perampanel...This review underscores the importance of tailoring treatment to predominant seizure types and calls for more rigorous, seizure-type-specific outcome reporting in future clinical trials, along with the need for long-term studies. The findings advocate for a precision, network-based approach to treatment, where therapeutic decisions are guided by individual seizure patterns and supported by evidence-based, seizure-type-specific efficacy data."

Journal • Review • Absence Seizure Disorder • CNS Disorders • Epilepsy

Identifying key targets and immune environment in wound healing based on iron overload-related genes. (PubMed, Arch Dermatol Res) - "Potential drugs for treating WH (e.g., felbamate, SA-94315, GANT-58, rucaparib) were identified. Cell experiments showed that EGFR could promote skin wound healing. The study suggested HIF1A, CDKN2A, and EGFR as potential diagnostic biomarkers for effective WH diagnosis, offering new insights into identifying potenti1al therapeutic targets for WH treatment."

Journal • Hematological Disorders • CDKN2A • EGFR • HIF1A • MIR200A • MIR218 • MIR218-1 • MIR218-2

Implementation and validation of a 24/7 system for the monitoring of antiepileptic drugs. (PubMed, Front Neurol) - "Matrix effects were within acceptable limits (<30% variation) for 23 of 26 analytes, with compensatory corrections applied for carbamazepine-D10, felbamate-D4, and levetiracetam-D6. Carry over was negligible [<2% for all AEDs except retigabine and N-desmethylselegiline (NDMS), which remained below 6.5%]...This study establishes a robust, fully automated, high-throughput method for continuous AED monitoring in the clinical setting. The CLAM-2030-LCMS-8060NX system enables reliable 24/7 TDM with minimal technical expertise, ensuring optimized AED therapy and improved patient outcomes."

Journal • CNS Disorders • Epilepsy

Efficacy and safety of pharmacological and non-pharmacological therapies in Lennox-Gastaut syndrome: a systematic review and network meta-analysis. (PubMed, Front Pharmacol) - "The treatments assessed included cannabidiol, fenfluramine, clobazam, rufinamide, felbamate, lamotrigine, topiramate, deep brain stimulation, and anterior corpus callosotomy. Clobazam 1 mg/kg/day, anterior corpus callosotomy, and rufinamide manifested the most optimal efficacy in seizure control among LGS patients. Caution should be exercised when administering cannabidiol, lamotrigine, and fenfluramine 0.7 mg/kg/day in clinical practice to mitigate safety concerns associated with drug-related side effects."

Journal • Retrospective data • Review • CNS Disorders • Epilepsy