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Toxicity of Antiepileptic Drugs to Mitochondria

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Pharmacology of Mitochondria

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 240))

Abstract

Some of the side and beneficial effects of antiepileptic drugs (AEDs) are mediated via the influence on mitochondria. This is of particular importance in patients requiring AED treatment for mitochondrial epilepsy. AED treatment in patients with mitochondrial disorders should rely on the known influences of AEDs on these organelles. AEDs may influence various mitochondrial functions or structures in a beneficial or detrimental way. There are AEDs in which the toxic effect outweighs the beneficial effect, such as valproic acid (VPA), carbamazepine (CBZ), phenytoin (PHT), or phenobarbital (PB). There are, however, also AEDs in which the beneficial effect on mitochondria outweighs the mitochondrion-toxic effect, such as gabapentin (GBT), lamotrigine (LTG), levetiracetam (LEV), or zonisamide (ZNS). In the majority of the AEDs, however, information about their influence of mitochondria is lacking. In clinical practice mitochondrial epilepsy should be initially treated with AEDs with low mitochondrion-toxic potential. Only in cases of ineffectivity or severe mitochondrial epilepsy, mitochondrion-toxic AEDs should be given. This applies for AEDs given orally or intravenously.

The author has nothing to declare.

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  1. Krankenanstalt Rudolfstiftung, Postfach 20, 1180, Vienna, Austria

    Josef Finsterer

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  1. Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA

    Harpreet Singh

  2. Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA

    Shey-Shing Sheu

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Finsterer, J. (2016). Toxicity of Antiepileptic Drugs to Mitochondria. In: Singh, H., Sheu, SS. (eds) Pharmacology of Mitochondria. Handbook of Experimental Pharmacology, vol 240. Springer, Cham. https://doi.org/10.1007/164_2016_2

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