Szájon át adható antiepileptikumok macskák részére Irodalmi összefoglaló

Abstract

Summary Background: Epilepsy is one of the most common diseases in feline neurology. Phenobarbital is the most frequently used anticonvulsant for feline epilepsy, but many other drugs have been already tested. Objectives: The objective of the present work is to analyse peroral antiepileptic treatment options for cats, compare different drugs, regarding their efficacy, side effects and application frequency. Materials and Methods: The encountered literature is critically concerning its strength for evidence (type and evidence of literature, and in case of studies, type, number of patients, observational period). Additionally, reference lists were used to find related records, respectively primary literature about feline epilepsy and diverse anticonvulsants. Results and Discussion: Fifteen drugs are currently described in the literature against feline epilepsy. Regarding their pharamacokinetics, pharmacodynamics, side effects and clinical experience, the authors recommend phenobarbital, zonisamide, levetiracetam for clinical use in epileptic cats. The use of bromide, diazepam, carbamazepine, propentofylline, taurin, gabapentin, pregabalin and topiramat is conditionally recommended. Primidone, phenytoin and valproic acid are not recommended. The information about anti-epileptic therapy in cats is based on expert opinions, case reports (Class IV) and a small number of prospective and retrospective studies (class III). Not a single Class I or II study (placebo controlled, randomized, double blind trial), describing the clinical efficacy is available. Furthermore, the small number of cats, insufficient observation time, simultaneous administration of different anticonvulsive drugs and missing comparative studies cause an additional decrease of evidence. In conclusion, the treatment of epilepsy in cats is based only on weak evidence.