Ethosuximide

From WikiMD

Ethosuximide is an succinimide based anticonvulsant commonly used for absence (petit mal) seizures in both adults and children. 

Liver safety of Ethosuximide

Ethosuximide has been associated with rare instances of serum enzyme elevations during treatment, but has not been linked to cases of clinically apparent liver injury with jaundice.

Mechanism of action of Ethosuximide

Ethosuximide (eth' oh sux" a mide) is a succinimide derivative and potent anticonvulsant that has been used to treat absence (petit mal) seizures for more than 50 years.  Ethosuximde reduces theshold calcium currents in thalamic neurons and suppresses the paroxysmal spike and wave activity that is associated with lapses of consciousness that occur with absence seizures. 

FDA approval information for Ethosuximide

Ethosuximide was approved for use in epilepsy in 1960 for use alone or in combination with other agents to treat absence seizures.  Ethosuximide is available as tablets of 250 mg and as syrup for pediatric use in several generic forms and under the brand name of Zarontin. 

Dosage and administration for Ethosuximide

The recommended initial dose in adults and children above the age of 6 years is 250 mg twice daily with dose escalation weekly based upon tolerance and effect. 

Side effects of Ethosuximide

Common side effects include dizziness, somnolence, ataxia, fatigue, irritability, anorexia and epigastric discomfort.  Rare, but potentially severe adverse events include hypersensitivity reactions and drug induced lupus erythematosus and scleroderma.

Anticonvulsants

Generic Name / Brand Name Liver Toxicity Score Approval Year Major Indications
Brivaracetam / Briviact E 2016 Partial seizures
Carbamazepine / Tegretol A 1968 Partial, mixed and generalized seizures, trigeminal neuralgia
Clobazam / Onfi E 2011 Seizures assocated with Lennox-Gastaut syndrome
Clonazepam / Klonopin D 1975 Absence and myoclonic seizures, anxiety and panic disorders
Clorazepate / Tranxene E 1972 Partial seizures, anxiety disorders, and alcohol withdrawal
Diazepam / Valium E 1963 Convulsions, anxiety disorders, muscle spasms
Eslicarbazepine / Aptiom D 2013 Partial seizures
Ethosuximide / Zarontin E 1960 Absence seizures
Ezogabine / Potiga E 2011 Partial seizures
Felbamate / Febatol B 1993 Refractory or severe epilepsy
Fosphenytoin / Cerebyx A 1996 Tonic-clonic seizures, status epilepticus
Gabapentin / Neurontin C 1993 Partial seizures, post-herpetic neuralgia
Lacosamide / Vimpat D 2008 Partial seizures
Lamotrigine / Lamictal B 1994 Partial and generalized tonic-clonic seizures, bipolar disorder
Levetiracetam / Keppra C 1999 Partial, generalized tonic-clonic, and myoclonic seizures
Methsuximide / Celontin E 1957 Absence seizures
Oxcarbazepine / Trileptal D 2000 Partial seziures
Perampanel / Fycompa E 2012 Partial and generalized tonic-clonic seizures
Phenobarbital / Luminal A 1916 Partial and generalized seizures, anxiety, and irritable bowel syndrome
Phenytoin / Dilantin A 1938 Generalized tonic-clonic and partial onset seizures, status epilepticus
Pregabalin / Lyrica C 2004 Partial seizures, fibromyalgia, and neuropathic pain
Primidone / Mysoline E 1954 Partial and generalized tonic-clonic seizures
Rufinamide / Banzel E 2008 Seizures associated with Lennox-Gastaut syndrome
Tiagabine / Gabitril E 1997 Partial seizures
Topiramate / Topamax C 1996 Partial and generalized tonic-clonic seizures, migraine headaches
Valproate / Depakene A 1978 Absence and complex partial seizures
Vigabatrin / Sabril D 2009 Refractory, complex partial seizures, and infantile spasms
Zonisamide / Zonegran D 2000 Partial seizures


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