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Other Pharmacological Therapies: Investigational Antiepileptic Drugs, Animal Models of Epilepsy, Hormonal Therapy, Immunotherapy

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Abstract

The investigation of antiepileptic drugs (AEDs) includes trials of new routes of delivery for marketed drugs, trials of marketed drugs for new indications, and trials of novel compounds. New routes of delivery are being tested in particular for benzodiazepines, in the treatment of seizure clusters by family members and other nonmedical caregivers. A large pivotal trial was completed for intramuscular diazepam administration by autoinjector, demonstrating intramuscular diazepam to be superior to placebo in preventing additional seizures and in obviating the need for other rescue treatment or emergency room visit.

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References

  1. Abou-Khalil B, Wheless J, Rogin J, et al. A double-blind, randomized, placebo-controlled trial of a diazepam auto-injector administered by caregivers to patients with epilepsy who require intermittent intervention for acute repetitive seizures. Epilepsia. 2013;54:1968–76.

    Article  CAS  PubMed  Google Scholar 

  2. Anonymous. Topiramate extended-release (Trokendi XR) for epilepsy. Med Lett Drugs Ther. 2013;55: 87–88.

    Google Scholar 

  3. Biton V, Shneker BF, Naritoku D, et al. Long-term tolerability and safety of lamotrigine extended-release: pooled analysis of three clinical trials. Clin Drug Investig. 2013;33:359–64.

    Article  CAS  PubMed  Google Scholar 

  4. Castel-Branco MM, Alves GL, Figueiredo IV, et al. The maximal electroshock seizure (MES) model in the preclinical assessment of potential new antiepileptic drugs. Methods Find Exp Clin Pharmacol. 2009;31:101–6.

    Article  CAS  PubMed  Google Scholar 

  5. Clark AM, Halvorsen MB, Braun TL, et al. USL255 extended-release topiramate: dose-proportional pharmacokinetics and tolerability in healthy volunteers. Epilepsia. 2014;55:1069–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Dalmau J, Gleichman AJ, Hughes EG, et al. Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol. 2008;7:1091–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. de Haan GJ, van der Geest P, Doelman G, et al. A comparison of midazolam nasal spray and diazepam rectal solution for the residential treatment of seizure exacerbations. Epilepsia. 2010;51:478–82.

    Article  PubMed  Google Scholar 

  8. Devinsky O, Cilio MR, Cross H, et al. Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia. 2014;55:791–802.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. French JA, Baroldi P, Brittain ST, et al. Efficacy and safety of extended-release oxcarbazepine (Oxtellar XR) as adjunctive therapy in patients with refractory partial-onset seizures: a randomized controlled trial. Acta Neurol Scand. 2014;129:143–53.

    Article  CAS  PubMed  Google Scholar 

  10. Goddard GV, McIntyre DC, Leech CK. A permanent change in brain function resulting from daily electrical stimulation. Exp Neurol. 1969;25:295–330.

    Article  CAS  PubMed  Google Scholar 

  11. Gordi T, Hou E, Kasichayanula S, et al. Pharmacokinetics of gabapentin after a single day and at steady state following the administration of gastric-retentive- extended-release and immediate-release tablets: a randomized, open-label, multiple-dose, three-way crossover, exploratory study in healthy subjects. Clin Ther. 2008;30:909–16.

    Article  CAS  PubMed  Google Scholar 

  12. Henney HR, 3rd, Sperling MR, Rabinowicz AL, et al. Assessment of pharmacokinetics and tolerability of intranasal diazepam relative to rectal gel in healthy adults. Epilepsy Res. 2014.

    Google Scholar 

  13. Herzog AG. Catamenial epilepsy: definition, prevalence pathophysiology and treatment. Seizure. 2008;17:151–9.

    Article  PubMed  Google Scholar 

  14. Herzog AG, Fowler KM, Smithson SD, et al. Progesterone vs placebo therapy for women with epilepsy: A randomized clinical trial. Neurology. 2012;78:1959–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Herzog AG, Klein P, Ransil BJ. Three patterns of catamenial epilepsy. Epilepsia. 1997;38:1082–8.

    Article  CAS  PubMed  Google Scholar 

  16. Holsti M, Dudley N, Schunk J, et al. Intranasal midazolam vs rectal diazepam for the home treatment of acute seizures in pediatric patients with epilepsy. Arch Pediatr Adolesc Med. 2010;164:747–53.

    Article  PubMed  Google Scholar 

  17. Irani SR, Michell AW, Lang B, et al. Faciobrachial dystonic seizures precede Lgi1 antibody limbic encephalitis. Ann Neurol. 2011;69:892–900.

    Article  PubMed  Google Scholar 

  18. Irani SR, Stagg CJ, Schott JM, et al. Faciobrachial dystonic seizures: the influence of immunotherapy on seizure control and prevention of cognitive impairment in a broadening phenotype. Brain. 2013;136:3151–62.

    Article  PubMed  Google Scholar 

  19. Kerrigan JF, Shields WD, Nelson TY, et al. Ganaxolone for treating intractable infantile spasms: a multicenter, open-label, add-on trial. Epilepsy Res. 2000;42:133–9.

    Article  CAS  PubMed  Google Scholar 

  20. Leppik IE, Hovinga CA. Extended-release antiepileptic drugs: a comparison of pharmacokinetic parameters relative to original immediate-release formulations. Epilepsia. 2013;54:28–35.

    Article  CAS  PubMed  Google Scholar 

  21. Loscher W. Critical review of current animal models of seizures and epilepsy used in the discovery and development of new antiepileptic drugs. Seizure. 2011;20:359–68.

    Article  PubMed  Google Scholar 

  22. Loscher W, Schmidt D. Which animal models should be used in the search for new antiepileptic drugs? A proposal based on experimental and clinical considerations. Epilepsy Res. 1988;2:145–81.

    Article  CAS  PubMed  Google Scholar 

  23. Marescaux C, Vergnes M, Depaulis A. Genetic absence epilepsy in rats from Strasbourg–a review. J Neural Transm Suppl. 1992;35:37–69.

    CAS  PubMed  Google Scholar 

  24. Marino SE, Birnbaum AK, Leppik IE, et al. Steady-state carbamazepine pharmacokinetics following oral and stable-labeled intravenous administration in epilepsy patients: effects of race and sex. Clin Pharmacol Ther. 2012;91:483–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. McKnight K, Jiang Y, Hart Y, et al. Serum antibodies in epilepsy and seizure-associated disorders. Neurology. 2005;65:1730–6.

    Article  CAS  PubMed  Google Scholar 

  26. Miro J, Fortuny R, Juncadella M, et al. Antithyroid antibodies as a potential marker of autoimmune-mediated late onset temporal lobe epilepsy. Clin Neurol Neurosurg. 2014;121:46–50.

    Article  PubMed  Google Scholar 

  27. Mula M. Brivaracetam for the treatment of epilepsy in adults. Expert Rev Neurother. 2014;14:361–5.

    Article  CAS  PubMed  Google Scholar 

  28. Naritoku DK, Warnock CR, Messenheimer JA, et al. Lamotrigine extended-release as adjunctive therapy for partial seizures. Neurology. 2007;69:1610–8.

    Article  CAS  PubMed  Google Scholar 

  29. Peltola J, Coetzee C, Jimenez F, et al. Once-daily extended-release levetiracetam as adjunctive treatment of partial-onset seizures in patients with epilepsy: a double-blind, randomized, placebo-controlled trial. Epilepsia. 2009;50:406–14.

    Article  CAS  PubMed  Google Scholar 

  30. Pennell PB. Hormonal aspects of epilepsy. Neurol Clin. 2009;27:941–65.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Rogawski MA, Loya CM, Reddy K, et al. Neuroactive steroids for the treatment of status epilepticus. Epilepsia. 2013;54(Suppl 6):93–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Rogin J, Wheless J, Abou-Khalil B, et al. Safety and effectiveness of long-term treatment with diazepam auto-injector administered by caregivers in an outpatient setting for the treatment of acute repetitive seizures. Epilepsia. 2014.

    Google Scholar 

  33. Silbergleit R, Durkalski V, Lowenstein D, et al. Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med. 2012;366:591–600.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Sperling M, Seif Eddeine H, Haas K, et al. Dosing feasibility and pharmacokinetics by seizure type and status, and tolerability of intranasal diazepam in adults with epilepsy. Epilepsy Currents. 2014;14 (Supplement—2013 Abstracts):106–7.

    Google Scholar 

  35. Steinhoff BJ. Oxcarbazepine extended-release formulation in epilepsy. Expert Rev Clin Pharmacol. 2009;2:155–62.

    Article  CAS  PubMed  Google Scholar 

  36. Toledano M, Britton JW, McKeon A, et al. Utility of an immunotherapy trial in evaluating patients with presumed autoimmune epilepsy. Neurology. 2014;82:1578–86.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Correspondence to Bassel Abou-Khalil .

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Abou-Khalil, B. (2017). Other Pharmacological Therapies: Investigational Antiepileptic Drugs, Animal Models of Epilepsy, Hormonal Therapy, Immunotherapy. In: Koubeissi, M., Azar, N. (eds) Epilepsy Board Review. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6774-2_19

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  • DOI: https://doi.org/10.1007/978-1-4939-6774-2_19

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