Guidelines for pharmacological treatment of epilepsy
Silvio Bašić, Željka Petelin Gadže, Igor Prpić, Zdravka Poljaković, Maša Malenica, Romana Gjergja Juraški, Ivana Marković, Ivana Šušak Sporiš, Jelena Šarić Jurić, Davor Sporiš, Stjepan Jurić, Sibila Nanković, Zlatko Sabol, Marija Meštrović, Vlatko Šulentić, Vlasta Đuranović, Maja Jurin, Nina Barišić, Iris Zavoreo, Zrinka Čolak Romić, Matilda Kovač Šižgorić, Anamarija Mrđen, Anka Shihabi Aleksić, Ljiljana Čengić, Milan Bitunjac, Marija Čandrlić, Dubravka Fajdetić, Ana Sruk, Robert Marčec, Ruža Kostanjevec, Boris Vuković, Marijan Cesarik, Vesna Kerek, Gordana Lojen, Lidija Šapina, Igor Cindrić, Dragan Smoljanac, Sanja Papić, Tihana Gržinčić, Marina Hlavati, Dunja Penavin Kolarić, Suzana Pejnović, Nevia Novak, Mario Grbin, Goran Ivkić
Epilepsy is the only chronic neurological disease that can be fully controlled by drugs or introduced into permanent remission. Nonetheless, pharmacological treatment of epilepsy is often accompanied by a range of diagnostic and therapeutic challenges. Due to a wide variety of available antiepileptics, the selection of the first antiepileptic, as well as the combination of polytherapy, is extremely large. The choice of the ideal antiepileptic is individual and depends on a variety of factors based on the pharmacological properties of the drug and the disctinctiveness of every patient (type of seizure, age,sex, profession, comorbidity, co-medication, etc.) with specific regulatory limitations (availability,price, indications of regulatory bodies). The basics of rational pharmacotherapy include slow titration of antiepileptics in monotherapy to satisfactory effect, slow drug replacement in the event of failure of the first antiepileptic, combination of two antiepileptics of different mechanism of action or selection of synergistic combinations if dual therapy is necessary, avoiding three or multiple polyterapies whenever possible, and slow reduction of antiepileptic drug after achieving a long-lasting remission.Current ILAE guidelines for epilepsy treatment imply basic and comprehensive recommendations that are acceptable worldwide, including countries with the lowest economic standard. Therefore, these guidelines do not reflect the ideal treatment options, especially in developed countries, and are actually the basis for making national guidelines. The Croatian guidelines for pharmacological treatment of epilepsy are the product of the co-operation of all
relevant professional societies and reference centers in the Republic of Croatia, headed by the Croatian League Against Epilepsy and the Croatian Neurological Society. These guidelines reflect the current socioeconomic specificities in our country,the latest knowledge of pharmacological profiles, and efficacy of certain antiepileptics as well as expert opinions.
Ana Sruk, Anamarija Mrđen, Anka Shihabi Aleksić, Boris Vuković, Davor Sporiš, Dragan Smoljanac, Dubravka Fajdetić, Dunja Penavin Kolarić, Goran Ivkić, Gordana Lojen, Igor Cindrić, Igor Prpić, Iris Zavoreo, Ivana Marković, Ivana Šušak Sporiš, Jelena Šarić Jurić, Lidija Šapina, Ljiljana Čengić, Maja Jurin, Marija Meštrović, Marija Čandrlić, Marijan Cesarik, Marina Hlavati, Mario Grbin, Matilda Kovač-Šižgorić, Maša Malenica, Milan Bitunjac, Nevia Novak, Nina Barišić, Robert Marčec, Romana Gjergja-Juraški, Ruža Kostanjevec, Sanja Papić, Sibila Nanković, Silvio Bašić, Stjepan Jurić, Suzana Pejnović, Tihana Gržinčić, Vesna Kerek, Vlasta Đuranović, Vlatko Šulentić, Zdravka Poljaković, Zlatko Sabol, Zrinka Čolak Romić, Željka Petelin Gadže