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https://www.readbyqxmd.com/read/28324910/lacosamide-lowers-valproate-and-levetiracetam-levels
#1
Maria Tountopoulou, Bernhard Weschke, Angela M Kaindl
Lacosamide (LCM) due to no known drug interaction and the absence of metabolic enzyme induction is a good candidate for an add-on medication, especially in combination with lamotrigine, levetiracetam (LEV), oxcarbazepine, topiramate, and valproic acid (VPA). Here we report for the first time, to our knowledge, that LCM can lower VPA and LEV serum levels. At present, there are no known explicable mechanisms of action of LCM, which lowers VPA and LEV. Here observed drug interaction of LCM is of clinical significance, which might be useful for other colleagues in the field...
March 21, 2017: Neuropediatrics
https://www.readbyqxmd.com/read/28315807/association-of-cyp2c9-cyp2a6-acsm2a-and-cpt1a-gene-polymorphisms-with-adverse-effects-of-valproic-acid-in-chinese-patients-with-epilepsy
#2
Can Wang, Ping Wang, Li-Ping Yang, Jing Pan, Xue Yang, Hong-Ying Ma
OBJECTIVE: To explore the influence of CYP2C9, CYP2A6, ACSM2A, CPT1A gene polymorphisms on valproic acid (VPA) and its role in metabolism-related liver dysfunction in order to guide the clinical safety and rational use of VPA. METHODS: One hundred two patients taking sodium valproate oral solution were genotyped. To assess the genotypes of relevant genes, the CYP2C9 gene was directly sequenced; for polymorphism classification, multiple Long-PCR electrophoresis was conducted for CYP2A6; and imLDR method was used for ACSM2A and CPT1A...
February 27, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28301219/management-of-comorbid-bipolar-disorder-and-substance-use-disorders
#3
Ihsan M Salloum, Edson Sherwood Brown
BACKGROUND: The comorbidity of substance use disorders (SUDs) in bipolar disorder is among the highest in psychiatric disorders. Evidence-based controlled psychosocial or pharmacological interventions trials, which may guide treatment decisions, have not been systematically reviewed. OBJECTIVE: To present a narrative review of the public health and clinical significance of this condition, including diagnostic and treatment implications, and to evaluate controlled trials conducted to date...
March 16, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28295557/parachlorophenylalanine-induced-5-ht-depletion-alters-behavioural-and-brain-neurotransmitters-levels-in-6-hertz-psychomotor-seizure-model-in-mice
#4
Kausar Jahan, Krishna K Pillai, Divya Vohora
The present study was designed to investigate the role of serotonin and other neurotransmitters namely dopamine (DA), histamine, noradrenaline (NA), glutamate and γ-amino-butyric acid (GABA) in the 6-hertz (6 Hz) induced psychomotor seizures in Swiss albino mice. Parachlorophenylalanine (PCPA, 300 mg/kg/day, i.p for 3 days) treated mice were given 6 Hz stimulation. Sodium valproate (SVP) [200 mg/kg/day, p.o for 3 days] was used as a reference anti-epileptic drug. The behavioral changes induced by 6Hz including increased rearing and grooming, Straub's tail, behavioral arrest, stun position etc were amplified by PCPA...
March 10, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28293110/efficacy-and-safety-of-oxcarbazepine-in-the-treatment-of-children-with-epilepsy-a-meta-analysis-of-randomized-controlled-trials
#5
Hua Geng, Chengzhong Wang
BACKGROUND: To assess the efficacy and safety of oxcarbazepine (OXC) in the treatment of children with epilepsy. METHODS: Randomized controlled trials (RCTs) published in PubMed, Embase, Web of Science, Cochrane Library, Scopus, SinoMed (Chinese BioMedical Literature Service System, China), and Chinese National Knowledge Infrastructure (China) database were systematically reviewed. Eligible studies were those that compared the efficacy and safety of OXC with other antiepileptic drugs in epilepsy...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28288483/efficacy-of-treatments-for-infantile-spasms-a-systematic-review
#6
Ji Min Song, Jongsung Hahn, Se Hee Kim, Min Jung Chang
OBJECTIVES: West syndrome (also known as infantile spasm because of its main seizure type) is a rare form of epilepsy that begins during early infancy. Recent guidelines and reviews on West syndrome recommend the use of adrenocorticotropic hormone steroids, or vigabatrin, as the first-line treatment. However, West syndrome remains to be one of the most challenging epilepsies to treat. Here, we systematically reviewed the current literature obtained during the previous decade. This article provides an overview of the current treatment of infantile spasms...
March 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28284397/optimizing-the-diagnosis-and-management-of-dravet-syndrome-recommendations-from-a-north-american-consensus-panel
#7
Elaine C Wirrell, Linda Laux, Elizabeth Donner, Nathalie Jette, Kelly Knupp, Mary Anne Meskis, Ian Miller, Joseph Sullivan, Michelle Welborn, Anne T Berg
OBJECTIVES: To establish standards for early, cost-effective, and accurate diagnosis; optimal therapies for seizures; and recommendations for evaluation and management of comorbidities for children and adults with Dravet syndrome, using a modified Delphi process. METHODS: An expert panel was convened comprising epileptologists with nationally recognized expertise in Dravet syndrome and parents of children with Dravet syndrome, whose experience and understanding was enhanced by their active roles in Dravet syndrome associations...
March 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28282553/challenges-in-the-treatment-of-convulsive-status-epilepticus
#8
REVIEW
Gaetano Zaccara, Gianfranco Giannasi, Roberto Oggioni, Eleonora Rosati, Luciana Tramacere, Pasquale Palumbo
Convulsive status epilepticus (CSE) is a medical emergency associated with high mortality and morbidity. The most recent definition of CSE is a convulsive seizure lasting more than 5min or consecutive seizures without recovery of consciousness. In adults, for the treatment of the early stages of CSE, diazepam, lorazepam or midazolam are the most common treatments, although the choice of agent seems less important than rapid treatment. Midazolam, when administered intramuscularly (best evidence), buccally, or nasally, is effective and safe in the pre-hospital setting...
February 28, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28281491/status-epilepticus-refractory-and-super-refractory
#9
REVIEW
Deepanshu Dubey, Jayantee Kalita, Usha K Misra
Status epilepticus (SE) is an important neurological emergency. It is defined as seizures lasting for 5 minutes or more or recurrent seizures without recovery of consciousness to baseline between the attacks. Refractory SE (RSE) is defined as SE persisting despite sufficient dose of benzodiazepines and at least one antiepileptic drug (AED), irrespective of time. Super refractory SE (SRSE) is defined as SE that continues for 24 hours or more after the use of anesthetic therapy, including cases that recur on weaning of the anesthestic agent...
2017: Neurology India
https://www.readbyqxmd.com/read/28281034/synergistic-anticonvulsant-effects-of-pregabalin-and-amlodipine-on-acute-seizure-model-of-epilepsy-in-mice
#10
Itefaq Hussain Qureshi, Azra Riaz, Rafeeq Alam Khan, Afaq Ahmed Siddiqui
Status epilepticus is a life threatening neurological medical emergency. It may cause serious damage to the brain and even death in many cases if not treated properly. There is limited choice of drugs for the short term and long term management of status epilepticus and the dugs recommended for status epilepticus possess various side effects. The present study was designed to investigate synergistic anticonvulsant effects of pregabalin with amlodipine on acute seizure model of epilepsy in mice. Pentylenetetrazole was used to induce acute seizures which mimic status epilepticus...
March 9, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/28280887/brivaracetam-population-pharmacokinetics-in-children-with-epilepsy-aged-1%C3%A2-month-to-16%C3%A2-years
#11
Rik Schoemaker, Janet R Wade, Armel Stockis
PURPOSE: The aims of the study were to develop a population pharmacokinetic model of orally administered brivaracetam in paediatric patients and to provide dosing suggestions. METHODS: Analysis included 600 brivaracetam plasma concentrations from a phase 2a study (NCT00422422; N01263) in 96 paediatric patients with epilepsy aged 1 month to 16 years, taking one to three concomitant antiepileptic drugs (AEDs). Pharmacokinetic analysis was performed using non-linear mixed effects modelling, and a stepwise covariate search was used to determine factors influencing brivaracetam clearance...
March 9, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28277033/efficacy-of-hydralazine-and-valproate-in-cutaneous-t-cell-lymphoma-a-phase-ii-study
#12
Jose Ramiro Espinoza-Zamora, Juan Labardini-Méndez, Alejandro Sosa-Espinoza, Celia López-González, Magnolia Vieyra-García, Myrna Candelaria, Valentin Lozano-Zavaleta, Diana Vanesa Toledano-Cuevas, Nidia Zapata-Canto, Eduardo Cervera, Alfonso Dueñas-González
OBJECTIVES: To evaluate the activity and safety hydralazine and valproate (Transkrip® in cutaneous T-cell lymphoma (CTCL). METHODS: Previously untreated and progressive/refractory CTCL patients received hydralazine at 83 mg or 182 mg/day for slow and rapid acetylators respectively plus magnesium valproate at a total dose of 30 mg/Kg t.i.d daily in continuous 28-day cycles in this phase II study. The primary objective was overall response rate (ORR) measured by the modified severity weighted assessment tool (m-SWAT), secondary end-points were time to response (TTR), time to progression (TTP), duration of response (DOR), progression-free survival (PFS), overall survival (OS) and safety...
February 15, 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28273397/associations-of-cyp2c9-and-cyp2a6-polymorphisms-with-the-concentrations-of-valproate-and-its-hepatotoxin-metabolites-and-vpa-induced-hepatotoxicity
#13
Mingming Zhao, Ti Zhang, Guofei Li, Feng Qiu, Yaxin Sun, Limei Zhao
The aim of this study was to compare genetic polymorphisms and concentrations of hepatotoxic metabolites in patients with epilepsy and liver injury and those with normal liver function receiving valproate monotherapy to identify risk factors for VPA-induced hepatotoxicity. A total of 279 Chinese patients with epilepsy were divided into an abnormal liver function (ANLFT) group (n=79) and a normal liver function (NLFT) group (n=200). PCR-RFLP, nested-PCR and direct sequencing were applied to identify the frequency of 8 SNPs in candidate genes...
March 8, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28255953/correlation-between-prescribed-daily-dose-seizure-freedom-and-defined-daily-dose-in-antiepileptic-drug-treatment
#14
László Horváth, Klára Fekete, Sándor Márton, István Fekete
Background Although defined daily doses (DDD) for antiepileptic drugs (AED) have been assigned only in combination therapy, based on the literature, most patients take them in monotherapy. Furthermore, discrepancies between DDD and prescribed daily dose (PDD) were observed. Objective First, to determine PDDs of AEDs and to reveal PDD/DDD ratio among seizure free versus not seizure free patients in everyday clinical practice. Second, to test the applicability of 75% cut-off of DDD to achieve seizure freedom...
March 2, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28245751/pharmacological-agents-to-reduce-readmissions-in-bipolar-disorder
#15
Jonathan Rogers, Matthew J Taylor
It is well recognized that medications have an important role to play in preventing relapse in bipolar disorder. The impact these treatments have on rates of admission to hospital in particular has been less well studied. We combined data on hospitalization from 11 randomized controlled trials in a network meta-analysis. We found that the published evidence demonstrates significant reductions in admission rates compared to placebo from lithium (risk ratio (RR) 0.44, 95% confidence interval (CI) 0.32-0.59), valproate (RR 0...
March 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28243149/antiepileptic-drugs-prescribed-in-pregnancy-and-prevalence-of-major-congenital-malformations-comparative-prevalence-studies
#16
Irene Petersen, Shuk-Li Collings, Rachel L McCrea, Irwin Nazareth, David P Osborn, Phil J Cowen, Cormac J Sammon
OBJECTIVE: The aim of this study was to examine the prevalence of major congenital malformations associated with antiepileptic drug (AED) treatment in pregnancy. PATIENTS AND METHODS: Using data from The Health Improvement Network, we identified women who have given live birth and their offspring. Four subgroups were selected based on the AED treatment in early pregnancy, valproate, carbamazepine, lamotrigine and women not receiving AED treatment. We compared the prevalence of major congenital malformations within children of these four groups and estimated prevalence ratios (PRs) using Poisson regression adjusted for maternal age, sex of child, quintiles of Townsend deprivation score and indication for treatment...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28242474/antiseizure-antidepressant-and-antipsychotic-medication-prescribing-in-elderly-nursing-home-residents
#17
Sai Praneeth R Bathena, Ilo E Leppik, Andres M Kanner, Angela K Birnbaum
OBJECTIVE: The incidence of epilepsy is highest in the elderly and the prevalence of epilepsy is higher in nursing home residents than in other cohorts. Co-medications that act in the central nervous system (CNS) are frequently prescribed in this population. The objective was to identify the most commonly prescribed antiseizure drugs (ASDs) and determine the frequency of use of antipsychotic and antidepressant medications in elderly nursing home residents receiving ASDs. METHODS: Data were obtained from a pharmacy database serving 18,752 patients in Minnesota and Wisconsin nursing homes...
February 24, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28240305/increased-pkc-activity-and-altered-gsk3%C3%AE-nmdar-function-drive-behavior-cycling-in-hint1-deficient-mice-bipolarity-or-opposing-forces
#18
Javier Garzón-Niño, María Rodríguez-Muñoz, Elsa Cortés-Montero, Pilar Sánchez-Blázquez
Mice with histidine triad nucleotide-binding protein 1 (HINT1) deletion exhibit manic-like symptoms that evolve into depressive-like behavior in response to stressful paradigms. Molecular and electrophysiological studies have indicated that HINT1(-/-) mice exhibit increased PKC, PKA, and GSK3β activities, as well as glutamate N-methyl-D-aspartate receptor (NMDAR)/α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic receptor (AMPAR) and NR2B/NR2A subunit ratios. Pharmacological interventions stabilized their behavior but through different mechanisms...
February 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28237319/epilepsy-treatment-in-adults-and-adolescents-expert-opinion-2016
#19
REVIEW
Jerry J Shih, Julia B Whitlock, Nicole Chimato, Emily Vargas, Steven C Karceski, Ryan D Frank
INTRODUCTION: There are over twenty anti-seizure medications and anti-seizure devices available commercially in the United States. The multitude of treatment options for seizures can present a challenge to clinicians, especially those who are not subspecialists in the epilepsy field. Many clinical questions are not adequately answered in double-blind randomized controlled studies. In the presence of a knowledge gap, many clinicians consult a respected colleague with acknowledged expertise in the field...
February 22, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28235655/association-between-antiepileptic-drug-dose-and-long-term-response-in-patients-with-refractory-epilepsy
#20
Nicholas P Poolos, Christina E Castagna, Stephen Williams, Alison B Miller, Tyler J Story
Seizures in patients with medically refractory epilepsy remain a substantial clinical challenge, not least because of the dearth of evidence-based guidelines as to which antiepileptic drug (AED) regimens are the most effective, and what doses of these drugs to employ. We sought to determine whether there were regions in the dosage range of commonly used AEDs that were associated with superior efficacy in patients with refractory epilepsy. We retrospectively analyzed treatment records from 164 institutionalized, developmentally disabled patients with refractory epilepsy, averaging 17years of followup per patient...
February 21, 2017: Epilepsy & Behavior: E&B
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