felbamate / Generic mfg. - LARVOL DELTA

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

Identification and validation of glycolysis-related diagnostic signatures in diabetic nephropathy: a study based on integrative machine learning and single-cell sequence. (PubMed, Front Immunol) - "Potential agents including esmolol, estradiol, ganciclovir, and felbamate, targeting the 12 diagnostic signatures were identified. An integrative machine learning frame established a novel diagnostic signature using glycolysis-related genes. This study provides a new direction for the early diagnosis and treatment of DN."

Biomarker • Journal • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Metabolic Disorders • Nephrology • Renal Disease • CD163 • ELF3 • PROM1 • S100A4 • SOX4 • TGFB1 • TNFAIP8

Antiseizure medications for Lennox-Gastaut Syndrome: Comprehensive review and proposed consensus treatment algorithm. (PubMed, Epilepsy Behav) - "To date, eight anti-seizure medications (ASMs) have been specifically approved by the U.S. Food and Drug Administration (FDA) for the treatment of LGS: clonazepam, felbamate, lamotrigine, topiramate, rufinamide, clobazam, cannabidiol, and fenfluramine. Barriers to access, including economic and regulatory hurdles, are also discussed. The proposed treatment algorithm emphasizes a personalized approach to LGS management, recommending valproate or clobazam as first-line treatments, followed by individualized combinations based on the specific patient profile and associated comorbidities."

Journal • Review • CNS Disorders • Epilepsy

Cognitive and behavioral impact of antiseizure medications, neuromodulation, ketogenic diet, and surgery in lennox-gastaut syndrome: A comprehensive review. (PubMed, Epilepsy Behav) - "Medications such as valproate, lamotrigine, cannabidiol, fenfluramine, levetiracetam, brivaracetam, felbamate, and rufinamide generally support cognitive stability, while topiramate and zonisamide are associated with cognitive challenges. Behavioral outcomes also vary: stability is observed with valproate, lamotrigine, rufinamide, cannabidiol, and fenfluramine, whereas medications like levetiracetam, perampanel, brivaracetam, clobazam, and zonisamide can increase aggression or irritability...Consideration of minimizing ASM polytherapy, careful evaluation of drug-drug interactions, pharmacogenomic implications, and the need for therapeutic drug monitoring in cases of cognitive adverse effects is essential. Future research should focus on developing assessment tools tailored to the unique needs of individuals with LGS, utilizing connectivity measures to assess intervention impacts, and advancing precision therapeutics to improve cognitive and behavioral outcomes."

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

Felbamate as a therapeutic alternative to drug-resistant genetic generalized epilepsy: a systematic review and meta-analysis. (PubMed, Neurol Sci) - "Patients with drug-resistant GGE achieved good responses to FBM. The high heterogeneity between studies calls for further research with large-scale, randomized controlled trials. Given the rare reports of idiosyncratic reactions of aplastic anemia and hepatic failure, intense laboratory monitoring and a slower titration schedule are recommended."

Journal • Retrospective data • Review • Aplastic Anemia • CNS Disorders • Epilepsy • Hematological Disorders • Hepatology • Liver Failure

Promising therapeutic strategies for lennox-gastaut syndrome: what's new? (PubMed, Expert Rev Neurother) - "Seven antiseizure medications (ASMs) in the US (six in the UK/EU) are licensed for the treatment of seizures in LGS: lamotrigine, topiramate, rufinamide, clobazam, felbamate (not licensed in the UK/EU), cannabidiol and fenfluramine. Although no major breakthroughs have been reported, several established and novel ASMs, some surgical strategies and other treatment approaches are of benefit or are showing promise. Progress remains incremental but any improvements in the management of this resistant epilepsy syndrome are worthwhile."

Journal • CNS Disorders • Epilepsy

Refining management strategies for Lennox-Gastaut syndrome: Updated algorithms and practical approaches. (PubMed, Epilepsia Open) - "If this is ineffective as monotherapy, adjunctive therapy with, firstly, lamotrigine and secondly, rufinamide, is recommended. If seizure control remains suboptimal, subsequent adjunctive ASM treatment options include (alphabetically) cannabidiol, clobazam, felbamate, fenfluramine, and topiramate, although evidence for these is more limited...Most people with LGS have learning difficulties and need a lot of support, often in residential care. The authors are experts in treating people with LGS and this article provides up-to-date guidance and advice on how best to care for those with the condition."

Journal • CNS Disorders • Epilepsy

Adjunctive Cenobamate in Children and Adolescents – Real-world Data from a Retrospective Multicenter Study (AES 2024) - "Funding: Not applicable Rationale: Cenobamate is a new oral antiseizure medication (ASM) associated with other carbamate-containing ASMs which have been in longstanding use such as felbamate...Dose reduction was performed in particular with lacosamide and clobazam due to suspected/reported interactions. Our study provides evidence that cenobamate is an effective and overall well-tolerated ASM in children and adolescents... Our study provides evidence that cenobamate is an effective and overall well-tolerated ASM in children and adolescents. Significantly, we demonstrate this in the younger pediatric population, which has not previously been reported in the literature. Our findings support the administration of cenobamate in children and adolescents with focal, drug resistant epilepsy as adjunctive therapy alongside the use of more established ASMs, although with caution required regarding drug interactions."

Real-world • Real-world evidence • Retrospective data • CNS Disorders • Developmental Disorders • Epilepsy • Mental Retardation • Pediatrics

Significant Seizure Frequency Reduction in a Patient with Refractory Bitemporal Lobe Epilepsy Following the Transition from High-frequency to Low-frequency Stimulation Settings in RNS System Therapy (AES 2024) - "He has trialed various antiseizure medications and currently takes Cenobamate, Felbamate, Fycompa, and Brivaracetam. Switching from HFS to LFS for our patient offered a substantial and meaningful reduction in seizure frequency. This case adds to the prior reported series of 10 patients, demonstrating that LFS could be an alternative approach for RNS patients poorly responsive to traditional HFS. Importantly, this report demonstrates that advanced RNS concepts can be relevant in highly underserved areas."

Clinical • CNS Disorders • Epilepsy

Cenobamate Provides Significant Reduction in Seizure Activity in Patients with Infantile Spasms (AES 2024) - "All patients had previously beentreated unsuccessfully with ACTH and vigabatrin (gold standard of therapy for such patients) aswell as with other antiseizure medications including valproate, felbamate, clobazam, topiramate,phenobarbital and others. There were 6 pediatric patients ages 22 months to 5 years old who had been treatedwith cenobamate. Cenobamate appears to be a helpful treatment for patients with infantile spasms asevidenced by considerable reductions in seizure activity and improvement in EEGs. In ouropinion, cenobamate should be considered when treatment with ACTH /steroids and vigabatrinis unsuccessful. By controlling seizures and spike load earlier in the disease, the risk ofdevelopmental cognitive delay will be reduced."

Clinical • CNS Disorders • Epilepsy • Pediatrics

Efficacy and Tolerability of Adjunctive Cenobamate in Pediatric and Adult Patients with Lennox Gastaut Syndrome (AES 2024) - "LGS is a childhood-onset epileptic encephalopathy often refractory to current treatments of valproate, clonazepam, topiramate, lamotrigine, felbamate, clobazam, rufinamide, cannabidiol and fenfluramine. Our data suggest promising efficacy and good tolerability of adjunctive CNB treatment in LGS patients. A prospective randomized control study is warranted."

Clinical • Ataxia • CNS Disorders • Epilepsy • Insomnia • Movement Disorders • Pain • Pediatrics • Psychiatry • Sleep Disorder