Editorial Material
Clinical Neurology
Wyatt P. Bensken, Ivan Sanchez Fernandez
Summary: One in four people in the United States who take prescription drugs face difficulties affording them, including patients with epilepsy. Health plans often restrict coverage for newer antiseizure medications, leading to delays in treatment. Neurologists can address this issue by understanding the causes and finding actionable solutions.
Review
Environmental Sciences
Jesus Daniel Cardoso-Vera, Gustavo Axel Elizalde-Velazquez, Hariz Islas-Flores, Alejandro Mejia-Garcia, Jose Mario Ortega-Olvera, Leobardo Manuel Gomez-Olivan
Summary: Antiepileptic drugs (AEDs) are increasingly used for indications beyond epilepsy treatment, leading to a global rise in their prescriptions and consumption. However, the removal efficiency of these drugs in wastewater treatment plants is low, posing a potential risk of groundwater contamination.
SCIENCE OF THE TOTAL ENVIRONMENT
(2021)
Article
Neurosciences
Xiaotong Yin, Yan Liu, Yang Guo, Limei Zhao, Guofei Li, Xiaoping Tan
Summary: The study found significant pharmacokinetic changes in newer antiepileptic drugs in women with epilepsy during pregnancy, highlighting the importance of therapeutic drug monitoring. It is recommended to monitor drug levels at least once per trimester and more frequently for women with poorly controlled seizures before pregnancy. Well-controlled seizures nine months before pregnancy can lower the risk of seizures during pregnancy, emphasizing the importance of pre-pregnancy counseling and seizure management.
CNS NEUROSCIENCE & THERAPEUTICS
(2022)
Review
Clinical Neurology
Roberta Roberti, Carmen De Caro, Luigi Francesco Iannone, Gaetano Zaccara, Simona Lattanzi, Emilio Russo
Summary: Cenobamate is a promising antiseizure medication for focal onset seizures in adults, with a unique mechanism of action and pharmacokinetic profile. Further clinical studies are needed to fully understand its clinical characteristics and potential interactions with other drugs.
Article
Pharmacology & Pharmacy
Shailly Mehrotra, Atul Bhattaram, Kevin Krudys, Michael Bewernitz, Ramana Uppoor, Mehul Mehta, Tao Liu, Philip Sheridan, Norman Hershkowitz, Nicholas Kozauer, Eric Bastings, Billy Dunn, Angela Yuxin Men
Summary: The US FDA has concluded that drugs approved for treating partial onset seizures in adults can be applied to pediatric patients aged one month and older, eliminating the need for independent efficacy trials. This study analyzes dosing, pharmacokinetic, exposure-response, and clinical data from eight approved drugs to support the extrapolation of efficacy in pediatric patients with partial onset seizures. The results show that based on disease similarity, response to treatment, and exposure-response relationships, the extrapolation of efficacy in pediatric patients aged one month and above is justified.
CLINICAL PHARMACOLOGY & THERAPEUTICS
(2022)
Review
Biochemistry & Molecular Biology
Kinga K. Borowicz-Reutt
Summary: This study analyzed the interactions between antidepressants and antiepileptic drugs in a mouse seizure model. Most antidepressants potentiated the effects of classical antiepileptic drugs, but mianserin and trazodone reduced the effects of certain drugs.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Article
Biochemistry & Molecular Biology
Kinga K. Borowicz-Reutt
Summary: Seizures can lead to severe cardiac arrhythmias, which increase the risk of SUDEP (sudden unexpected death in epilepsy). It is important for epilepsy patients with pre-existing arrhythmias to receive appropriate pharmacotherapy. However, the use of antiarrhythmic and antiseizure medications together can result in drug-drug interactions.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Multidisciplinary Sciences
Yadeta Babu Beyene, Fekede Bekele Daba, Kabaye Kumela Goro, Birbirsa Sefera Senbeta
Summary: This study aimed to assess the drug therapy problems and predicting factors among ambulatory epileptic patients at Jimma University Medical Center. The results showed that the majority of patients had drug therapy problems, with non-compliance, adverse drug reactions, and low dosage being the most common problems. Getting drugs by purchasing, poor involvement in therapeutic decision making, uncontrolled seizures, and taking multiple medications were identified as independent predictors of drug therapy problems.
Article
Medicine, General & Internal
Rod W. Hunt, Helen G. Liley, Deepika Wagh, Rachel Schembri, Katherine J. Lee, Andrew D. Shearman, Samantha Francis-Pester, Koert DeWaal, Jeanie Y. L. Cheong, Monika Olischar, Nadia Badawi, Flora Y. Wong, David A. Osborn, Victor Samuel Rajadurai, Peter A. Dargaville, Bevan Headley, Ian Wright, Paul B. Colditz
Summary: This randomized clinical trial aimed to determine whether active management of electrographic and clinical seizures in encephalopathic term or near-term neonates improved survival free of severe disability at 2 years compared with only treating clinically detected seizures. The study found that treating electrographic and clinical seizures with currently used anticonvulsants did not significantly reduce the rate of death or disability at 2 years in a heterogeneous group of neonates with seizures. Additionally, there was evidence that cognitive outcomes were worse in the group where both types of seizures were actively managed.
Article
Clinical Neurology
Maria Gogou, Suresh Pujar, Tarishi Nemani, Chunyi Chiang, Zoe Simpson, Isobel Hardy, Natasha Schoeler, J. Helen Cross, Christin Eltze
Summary: This study retrospectively analyzed the successful withdrawal of antiseizure medication (ASM) after implementing the ketogenic diet in children with epilepsy. It found that younger age at the start of the diet was associated with higher odds of successful withdrawal of ASM.
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY
(2022)
Article
Clinical Neurology
Meike Schelhaas, Ilse Wegner, Mireille Edens, Elisabeth Wammes-Van der Heijden, Daniel Touw, Peter Ter Horst
Summary: This study found that the concentration/dose ratio of levetiracetam decreases during pregnancy, but there is still a new target concentration range that is relatively safe. For patients who have had seizures within one year before pregnancy, the decrease in levetiracetam concentration is significantly correlated with seizure frequency deterioration.
Article
Biochemistry & Molecular Biology
Mikio Kakumoto, Kosuke Shimokawa, Satoshi Ueshima, Daiki Hira, Tomonobu Okano
Summary: Studies suggest that exposure to valproic acid during fetal development may impact intelligence quotient, but the exact mechanisms remain unclear. This research utilized a neuroblastoma cell line to investigate the effects of antiepileptic drugs containing valproic acid on nerve cells, revealing some drugs to be toxic and valproic acid potentially influencing gene expression related to neurodevelopment.
BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS
(2021)
Article
Agriculture, Dairy & Animal Science
Sylvia Garcia-Belenguer, Laura Grasa, Olga Valero, Jorge Palacio, Isabel Luno, Belen Rosado
Summary: The study found differences in gut microbiota composition between epileptic dogs and control dogs, with drug-naive epileptic dogs showing significantly reduced abundance of GABA and SCFAs-producing bacteria, as well as bacteria associated with reduced risk for brain disease. Furthermore, the administration of antiepileptic drugs for a month did not alter the gut microbiota composition. These results may contribute to understanding canine idiopathic epilepsy and offer potential for exploring probiotic intervention as a therapeutic approach.
Article
Behavioral Sciences
Deepti Zutshi, Scott R. Millis, Maysaa M. Basha, Maha A. Daimee, Meghana Srinivas
Summary: This study aimed to determine the impact of pregnancy on serum LCM levels in women with epilepsy, and found that LCM levels decreased during pregnancy, particularly in the second and third trimesters. Despite the decrease in DNC levels, there were no significant changes in seizure frequency, and none of the neonates showed teratogenic findings at birth.
EPILEPSY & BEHAVIOR
(2021)
Article
Clinical Neurology
Kimford J. Meador, Morris J. Cohen, David W. Loring, Abigail G. Matthews, Carrie Brown, Chelsea P. Robalino, Angela K. Birnbaum, Paula E. Voinescu, Laura A. Kalayjian, Elizabeth E. Gerard, Evan R. Gedzelman, Julie Hanna, Jennifer Cavitt, Maria Sam, Jacqueline A. French, Sean Hwang, Alison M. Pack, Page B. Pennell, MONEAD Invest Grp
Summary: This study aimed to investigate the neurodevelopmental effects of fetal exposure to commonly used antiseizure medications, and found no difference in neurodevelopmental outcomes between children with fetal exposure to newer antiseizure medications compared with unexposed children.
