Emerging treatments
Losigamone
A b-methoxy-butenolide with an unknown mechanism of action. One Cochrane review of two randomised placebo-controlled trials (467 participants) found that losigamone can reduce seizure frequency when used as an add-on therapy for people with focal epilepsy.[167]
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Treatment withdrawals were significantly more common among participants receiving add-on therapy with losigamone.
Ganaxolone
A neurosteroid that acts through positive allosteric modulation of gamma-aminobutyric acid A receptor sites. Adjunctive ganaxolone reduced seizure frequency in a phase 2 trial of patients with uncontrolled focal-onset seizures despite taking up to three concomitant anticonvulsants.[168]
Topiramate (intravenous)
The US Food and Drug Administration (FDA) has granted orphan-drug designation to intravenous topiramate for the treatment of focal-onset or primary generalised tonic-clonic seizures in hospitalised epilepsy patients who are unable to take oral topiramate.
Cannabidiol
Cannabidiol oral solution has been approved by the FDA and the European Medicines Agency for the treatment of seizures associated with Lennox-Gastaut syndrome or Dravet syndrome. Multicentre, randomised, placebo-controlled trials are required to investigate efficacy in patients with severe, treatment-resistant focal seizures.[169]
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