Effectiveness of Non-benzodiazepine Antiepileptic Drugs in Benzodiazepine-resistant ‎Convulsive Status Epilepticus: A Review

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Time-dependent pharmacoresistance is a major therapeutic problem in SE and CSE. As seizures continue, pharmacoresistance develops progressively. The anti-seizure effectiveness of benzodiazepines could reduce 20-fold in 30 min of seizures. The objective of this study is to précis the existing proof that compares ‎the effect of valproate, phenytoin, diazepam, ‎‎phenobarbital, lacosamide, and levetiracetam on benzodiazepine-resistant convulsive status ‎‎epilepticus.‎ This systematic review was conducted, including PubMed, Google Scholar, and EBSCO that examining randomized trials of non-benzodiazepine antiepileptic drugs in benzodiazepine-resistant ‎convulsive status epilepticus. Authors extracted the data, and then the author's names, year and region of publication, the study type, period of study, and the result were reported.  

The review included 9 randomized studies that compared non-benzodiazepine antiepileptic drugs in terms of efficacy and adverse effects for SE management. Valproate, phenytoin, diazepam, ‎‎phenobarbital, lacosamide, and levetiracetam are all conventional agents that could be given as second-line management of status epilepticus and in cases of benzodiazepine-resistant convulsive status ‎‎epilepticus. Though, the use of these medications is restricted due to their toxicity.