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https://www.readbyqxmd.com/read/29243813/antiepileptic-drug-monotherapy-for-epilepsy-a-network-meta-analysis-of-individual-participant-data
#1
REVIEW
Sarah J Nevitt, Maria Sudell, Jennifer Weston, Catrin Tudur Smith, Anthony G Marson
BACKGROUND: Epilepsy is a common neurological condition with a worldwide prevalence of around 1%. Approximately 60% to 70% of people with epilepsy will achieve a longer-term remission from seizures, and most achieve that remission shortly after starting antiepileptic drug treatment. Most people with epilepsy are treated with a single antiepileptic drug (monotherapy) and current guidelines from the National Institute for Health and Care Excellence (NICE) in the United Kingdom for adults and children recommend carbamazepine or lamotrigine as first-line treatment for partial onset seizures and sodium valproate for generalised onset seizures; however a range of other antiepileptic drug (AED) treatments are available, and evidence is needed regarding their comparative effectiveness in order to inform treatment choices...
December 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29220742/meta-analyses-of-newer-antiepileptic-drugs-as-adjunct-for-treatment-of-focal-epilepsy-in-children
#2
Nurul-Ain Mohd-Tahir, Shu-Chuen Li
AIM: This study conducted a systematic review evaluating the effectiveness of newer antiepileptic drugs (AEDs) (namely, lamotrigine, levetiracetam, topiramate, vigabatrin, zonisamide, oxcarbazepine, perampanel, gabapentin, and stiripentol) as add-on for treatment of focal epilepsy in children. METHODS: Articles were retrieved from EMBASE, Medline and Cochrane Library from inception to January 2016. Treatment outcomes were analysed based on responder, seizure-free, withdrawal and adverse event rates...
November 22, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29213044/-the-course-and-development-of-epilepsy-in-patients-with-typical-variant-of-rett-syndrome-and-mutations
#3
M Yu Bobylova, I V Ivanova, I V Nekrasova, O A Pylaeva, K Yu Mukhin, A A Kholin, Ek S Iljina, A V Kulikov, El S Iljina, Yu E Nesterovsky
AIM: To study the anamnesis, clinical state, electro-encephalographic and brain MRI characteristics in patients with Rett syndrome (МЕСР2) and epilepsy. MATERIAL AND METHODS: Eleven female patients, aged from 3 to 23 years, with Rett syndrome and MeCP2 mutations were studied. The study continued for 10 years (2006-2015). Assessment of neurological and mental status, night sleep video-EEG monitoring, MRI were performed. RESULTS AND CONCLUSION: Epilepsy was diagnosed in six cases (54...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/29190192/suspected-zonisamide-related-anticonvulsant-hypersensitivity-syndrome-in-a-cat
#4
Audrey Collinet, Veronique Sammut
CASE DESCRIPTION A 2-year-old neutered male domestic shorthair cat was evaluated for sudden onset of cluster seizures. CLINICAL FINDINGS At an emergency clinic, the cat had hyperimmunoglobulinemia and thrombocytopenia. On referral, treatment with levetiracetam, zonisamide, and phenobarbital initially provided good control of cluster seizure activity (attributable to epilepsy of unknow origin). Two weeks later, assessments revealed that serum phenobarbital concentration was within the ideal range but serum zonisamide concentration exceeded the recommended therapeutic range...
December 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29133176/effect-of-zonisamide-on-refractory-epilepsy-during-pregnancy-in-lamotrigine-resistant-kindled-rats
#5
Reza Narenji Sani, Keivan Keramati, Niloufar Saberi, Melika Moezifar, Ali Mahdavi
Drug-resistant epilepsy with uncontrolled severe seizures despite state-of-the-art medical treatment continues to be a major clinical problem. Pregnancy is a state where drug pharmacokinetic changes are more pronounced and more rapid than any other period of life. The current study investigated the effect of zonisamide (ZNS) on refractory epilepsy during pregnancy in lamotrigine-resistant kindled rats. Fifty-six lamotrigine (LTG)-resistant kindled Wistar rats were divided into five experimental (four pregnant and one non-pregnant) and 2 positive controls (pregnant and non-pregnant) groups and eight intact Wistar rats were put in the negative pregnant control group...
November 11, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/29124439/lennox-gastaut-syndrome-a-comprehensive-review
#6
Ali A Asadi-Pooya
Lennox-Gastaut syndrome (LGS) is considered an epileptic encephalopathy and is defined by a triad of multiple drug-resistant seizure types, a specific EEG pattern showing bursts of slow spike-wave complexes or generalized paroxysmal fast activity, and intellectual disability. The prevalence of LGS is estimated between 1 and 2% of all patients with epilepsy. The etiology of LGS is often divided into two groups: identifiable (genetic-structural-metabolic) in 65 to 75% of the patients and LGS of unknown cause in others...
November 9, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/29110561/efficacy-of-zonisamide-on-interictal-electroencephalography-in-familial-spontaneous-epileptic-cats
#7
Masayasu Ukai, Yuji Hamamoto, Yoshihiko Yu, Aki Fujiwara-Igarashi, Michio Fujita, Daisuke Hasegawa
Objectives The effectiveness of zonisamide (ZNS) against spontaneous epilepsy in cats has not yet been described. The purpose of this study was to investigate the effect of ZNS on interictal paroxysmal discharges (PDs) using scalp electroencephalography (EEG) in familial spontaneous epileptic cats (FSECs). Methods Eight FSECs were evaluated (six males and two females). Scalp EEG measurements were performed once a week for 3 weeks before ZNS administration (Pre-ZNS). Thereafter, administration of ZNS was started and an adjustment period was instituted until the drug in plasma achieved the steady state...
November 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/29098923/sulphonamide-inhibition-studies-of-the-%C3%AE-carbonic-anhydrase-from-the-bacterial-pathogen-clostridium-perfringens
#8
Daniela Vullo, R Siva Sai Kumar, Andrea Scozzafava, James G Ferry, Claudiu T Supuran
The β-carbonic anhydrases (CAs, EC 4.2.1.1) from the pathogenic bacterium Clostridium perfringens (CpeCA) was recently characterised kinetically and for its anion inhibition profile. In the search of effective CpeCA inhibitors, possibly useful to inhibit the growth/pathogenicity of this bacterium, we report here an inhibition study of this enzyme with a panel of aromatic, heterocyclic and sugar sulphonamides/sulphamates. Some sulphonamides, such as acetazolamide, ethoxzolamide, dichlorophenamide, dorzolamide, sulthiame and 4-(2-hydroxymethyl-4-nitrophenyl-sulphonamido)ethylbenzenesulphonamide were effective CpeCA inhibitors, with KIs in the range of 37...
December 2018: Journal of Enzyme Inhibition and Medicinal Chemistry
https://www.readbyqxmd.com/read/29076421/seizures-and-anticonvulsants-in-brain-tumours-frequency-mechanisms-and-anti-epileptic-management
#9
Charles Vecht, Louis Royer-Perron, Caroline Houillier, Gilles Huberfeld
In cancer, epilepsy can be the manifestation of a primary brain tumour, metastatic disease, vascular or surgical complications, opportunistic infection or secondary to anti-tumour therapy. Seizures are frequently the first symptom of a brain tumour. The epilepsy is related to elevated extracellular glutamate stimulating NMDA- and AMPA-receptors and to the formation of D-2HG which resembles glutamate in IDH1 mutated gliomas. Epilepsy as presenting sign is associated with a longer survival in low- and high- grade gliomas, particularly with the IDH1 mutation...
October 27, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29073578/long-term-retention-rates-for-antiepileptic-drugs-a-review-of-long-term-extension-studies-and-comparison-with-brivaracetam
#10
REVIEW
Manuel Toledo, Rebecca Beale, Jennifer S Evans, Sara Steeves, Sami Elmoufti, Rebecca Townsend, John Whitesides, Simon Borghs
Antiepileptic drug (AED) retention rates are frequently reported in the literature and used to inform clinical decision-making, but methodological differences in the determination of retention rates make comparisons between trials difficult. Open-label extension (OLE) studies of AEDs in patients with focal epilepsy were identified from the literature. Retention calculation methods were reviewed, and published AED retention rates qualitatively compared with corresponding data for brivaracetam (BRV), a synaptic vesicle protein 2A ligand...
October 10, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29071470/the-challenge-of-pharmacotherapy-in-children-and-adolescents-with-epilepsy-adhd-comorbidity
#11
REVIEW
Alberto Verrotti, Romina Moavero, Gianvito Panzarino, Claudia Di Paolantonio, Renata Rizzo, Paolo Curatolo
Epilepsy is common in children and adolescents where its prevalence is 3.2-5.5/1000. About one-third of patients also have attention deficit hyperactivity/impulsivity disorder (ADHD). The possible relationship between epilepsy and ADHD is still unclear, and ADHD symptoms (such as inattention, hyperactivity, behavioral disturbances) are frequently considered as adverse effects of antiepileptic drugs (AEDs). The literature was searched for data on the behavioral effects of AEDs. Phenobarbital is the most frequently reported medication to induce symptoms of ADHD, followed by topiramate and valproic acid...
October 25, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28957723/behavioral-effects-of-antiepileptic-drugs-in-rats-are-the-effects-on-mood-and-behavior-detectable-in-open-field-test
#12
Eva Zimcikova, Julius Simko, Iva Karesova, Jan Kremlacek, Jana Malakova
PURPOSE: Behavioral side effects of antiepileptic drugs (AEDs) are common including both positive and negative effects on mood, anxiety, depression, and psychosis. We aimed to evaluate behavioral patterns in rats after administration of lamotrigine, levetiracetam, phenytoin, topiramate, carbamazepine, gabapentin, pregabalin, and zonisamide. METHODS: The open-field test was performed and locomotion, rearing, grooming, central latency and defecation were recorded over a 5min interval for each rat (8 rats in each group receiving AED and 16 controls)...
September 20, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28950817/specific-patient-features-affect-antiepileptic-drug-therapy-decisions-focus-on-gender-age-and-psychiatric-comorbidities
#13
Laura Rosa Pisani, Marina Nikanorova, Cecilie Johannessen Landmark, Svein Ivar Johannessen, Francesco Pisani
BACKGROUND: Patient features, apart from the type of seizures/epilepsy, affect markedly antiepileptic drug (AED) choice and dosage. The present review focuses on gender, age and psychiatric comorbidities which play a leading role in influencing antiepileptic treatment. METHODS: Reviews with large population of patients, controlled clinical trials, observational investigations, experimental studies and experimental reviews of experimental data, where appropriated, were analysed and illustrated to produce the most homogeneous indications possible...
September 25, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28943819/evaluation-of-safety-in-exceeding-maximum-adult-doses-of-commonly-used-second-generation-antiepileptic-drugs-in-pediatric-patients
#14
Mindl M Messinger, Sunita N Misra, Gary D Clark, Shannon M DiCarlo
OBJECTIVE: Pediatric patients often require larger doses of antiepileptic drug (AED) than adults in order to attain therapeutic serum concentrations and/or achieve seizure control. Safety and efficacy data are often extrapolated from adult literature; hence, optimal dosage may only be determined anecdotally or based on expert opinion. With limited pediatric dosing guidelines, milligrams per day that are based on weight may exceed the maximum adult dose. The primary objective of this study is to evaluate the safety of exceeding maximum doses as specified by the US Food and Drug Administration or manufacturers of commonly used AEDs in pediatric patients...
July 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28931473/psychiatric-and-behavioral-side-effects-of-antiepileptic-drugs-in-adults-with-epilepsy
#15
Baibing Chen, Hyunmi Choi, Lawrence J Hirsch, Austen Katz, Alexander Legge, Richard Buchsbaum, Kamil Detyniecki
PURPOSE: Psychiatric and behavioral side effects (PBSEs) are common, undesirable effects associated with antiepileptic drug (AED) use. The objective of the study was to compare the PBSE profiles of older and newer AEDs in a large specialty practice-based sample of patients diagnosed with epilepsy. METHODS: As part of the Columbia and Yale AED Database Project, we reviewed patient records including demographics, medical history, AED use, and side effects for 4085 adult patients (age: 18 years) newly started on an AED regimen...
November 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28928441/effects-of-anti-epileptic-drugs-on-spreading-depolarization-induced-epileptiform-activity-in-mouse-hippocampal-slices
#16
Ching-Huei Lin, Shih-Pin Hsu, Ting-Chun Cheng, Chin-Wei Huang, Yao-Chang Chiang, I-Han Hsiao, Ming-Hsueh Lee, Mei-Lin Shen, Dong Chuan Wu, Ning Zhou
Epilepsy and spreading depolarization (SD) are both episodic brain disorders and often exist together in the same individual. In CA1 pyramidal neurons of mouse hippocampal slices, induction of SD evoked epileptiform activities, including the ictal-like bursts, which occurred during the repolarizing phase of SD, and the subsequent generation of paroxysmal depolarization shifts (PDSs), which are characterized by mild depolarization plateau with overriding spikes. The duration of the ictal-like activity was correlated with both the recovery time and the depolarization potential of SD, whereas the parameters of PDSs were not significantly correlated with the parameters of SD...
September 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28927711/efficacy-tolerability-and-retention-rates-of-zonisamide-in-older-adult-patients-with-focal-onset-epilepsy-experiences-from-two-tertiary-epilepsy-centers
#17
Ebru Apaydın Doğan, Emine Genç, Bülent Oğuz Genç, Çağla Erdoğan
OBJECTIVE: The objective of this study was to evaluate the efficacy, tolerability, and retention rates for zonisamide (ZNS) in older adult patients with focal-onset epilepsy. PATIENTS AND METHODS: Chart reviews of patients aged 60years and older with focal-onset epilepsy treated with ZNS in two tertiary epilepsy centers were analyzed retrospectively. RESULTS: Eighty-five patients (41 males, 44 females) aged over 60years (range: 60-81) with focal-onset epilepsy treated with ZNS were identified; 55...
September 15, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28865097/suspected-phenobarbital-induced-pseudolymphoma-in-a-dog
#18
R Lampe, J Manens, N Sharp
Pseudolymphoma is a drug reaction to anti-epileptics that is well recognized in humans; it has been reported in one cat but not dogs. In this report, lymphoma-like clinical signs are suspected to be secondary to phenobarbital administration in a dog. A 2.5-year-old male, neutered Shepherd mix presented for a 3-day history of progressive ataxia, dazed mentation, pyrexia, and lethargy. While hospitalized, the dog developed generalized lymphadenopathy and sustained pyrexia. The dog was receiving levetiracetam and phenobarbital for epilepsy, and serum concentrations of both were within standard therapeutic ranges...
September 2, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28836659/zonisamide-for-essential-tremor
#19
REVIEW
Elisa Bruno, Alessandra Nicoletti, Graziella Filippini, Graziella Quattrocchi, Carlo Colosimo, Mario Zappia
BACKGROUND: Essential tremor (ET) is one of the most common movement disorders. The treatment is primarily based on pharmacological agents. Although primidone and propranolol are well established treatments in clinical practice, they can be ineffective in 25% to 55% of patients, and can produce serious adverse events in a large percentage of them. For these reasons, it may be worthwhile evaluating the treatment alternatives for ET. Zonisamide has been suggested as a potentially useful agent for the treatment of ET but there is uncertainty about its efficacy and safety...
August 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28815754/pharmacokinetic-interactions-and-dosing-rationale-for-antiepileptic-drugs-in-adults-and-children
#20
S C van Dijkman, W M Rauwé, M Danhof, O Della Pasqua
AIM: Population pharmacokinetic modelling has been widely used across many therapeutic areas to identify sources of variability, which are incorporated into models as covariate factors. Despite numerous publications on pharmacokinetic (PK) drug-drug interactions (DDIs) between antiepileptic drugs (AEDs), such data are not used to support the dose rationale for polytherapy in the treatment of epileptic seizures. Here we assess the impact of DDIs on plasma concentrations and evaluate the need for AED dose adjustment...
August 16, 2017: British Journal of Clinical Pharmacology
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