Clinical Medicine Insights: Therapeutics

Partial seizures are frequently resistant to pharmacologic treatment. There are a plethora of medications currently approved for use in partial epilepsy. However, despite the large number of medications available, seizure control often remains elusive. A new medication with a unique mechanism of action has recently been approved for the adjunctive treatment of partial seizures in adults. Ezogabine (retigabine) exerts its actions at the level of voltage-gated potassium channels. In clinical trials it has demonstrated efficacy similar to that of other agents approved for resistant partial epilepsy. Adverse events tend to be central nervous system related. However, significant urinary retention has been noted in some persons exposed to the drug. A Risk Evaluation and Mitigation Strategy is being implemented to minimize urinary adverse events. Ezogabine represents an important addition to the partial epilepsy medication arsenal.