Current Pharmaceutical Design - Volume 23, Issue 37, 2017

Background: Emerging evidence suggests that epigenetic mechanisms are involved in different brain functions such as the development of the nervous system and normal neuronal function. At the same time, it has been proposed that several neurological diseases are in part, caused by aberrant epigenetic modifications. Nevertheless, the mechanisms underlying pathological alterations in the brain genome are not compl Read More

Background: A variety of evidence suggested that an imbalance in excitatory and inhibitory neurotransmission could be one of the pathophysiological mechanisms underlying the occurrence and progression of seizures. Understanding the causes of this imbalance may provide essential insight into the basic mechanisms of epilepsy and may uncover novel targets for future drug therapies. Accordingly, GABA is th Read More

Background: The lack of treatments which can prevent epilepsy development or improve disease prognosis represents an unmet and urgent clinical need. The development of such drugs requires a deep understanding of the mechanisms underlying disease pathogenesis. In the last decade, preclinical studies in models of acute seizures and of chronic epilepsy highlighted that neuroinflammation arising in brain areas Read More

Background: The benign character of absence epilepsy compared to other genetic generalized epilepsy syndromes has often hampered the search for new treatment options. Absence epilepsy is most often treated with ethosuximide or valproic acid. However, both drugs are not always well tolerated or fail, and seizure freedom for a larger proportion of patients remains to be achieved. The availability of genuine animal mod Read More

Background: Animal models when carefully selected, designed and conducted, are important parts of any translational drug development strategy. However, research of new compounds for patients with drugresistant epilepsies is still based on animal experiments, mostly in rodents, which are far from being a model of chronic human epilepsy and have failed to differentiate the efficacy of new compounds versus standard drug Read More

Background: Despite the introduction of new antiepileptic drugs (AEDs), the quality of life and therapeutic response for patients with epilepsy remain unsatisfactory. In addition, whilst several antiepileptic drugs (AEDs) have been approved and consequently marketed in recent years, little is known about their long-term safety and tolerability. Availability of the newest AEDs, characterized by improved pharmacokinetic profiles, Read More

Background: Prior articles paid little attention to pharmacodynamic drug interactions (DIs) between antiepileptic drugs (AEDs) and the most important psychotropic medications (antidepressants, antipsychotics, benzodiazepines and lithium) which have potential to be clinically relevant. Objective: This article aims to provide an updated review of the potentially clinically relevant pharmacodynamic DIs between AEDs and p Read More

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 exp Read More

Background: Sexual dysfunction is very common in patients with epilepsy. Objective: We sought to review the published literature around sexual dysfunction in epilepsy, and particularly the role played by anticonvulsant drugs. Method: We searched all related articles on PubMed using the search terms sexual dysfunction, various AEDs and epilepsy, and restricted the search to English language articles. Results: The most co Read More

Background: Progressive myoclonus epilepsies (PMEs) are a group of rare inherited diseases featuring a combination of myoclonus, seizures and variable degree of cognitive impairment. Despite extensive investigations, a large number of PMEs remain undiagnosed. In this review, we focus on the current pharmacological approach to PMEs. Methods: References were mainly identified through PubMed search until February 2017 Read More

Background: Epileptic encephalopathies represent the most severe epilepsies, with onset in infancy and childhood and seizures continuing in adulthood in most cases. New genetic causes are being identified at a rapid rate. Treatment is challenging and the overall outcome remains poor. Available targeted treatments, based on the precision medicine approach, are currently few. Objective: To provide an overview of the tr Read More

Background: Although a larger number of antiepileptic drugs became available in the last decades, epilepsy remains drug-resistant in approximately a third of patients. Ketogenic diet (KD), first proposed at the beginning of the last century, is complex and has anticonvulsant effects, yet not completely understood. Over the last decades, different types of ketogenic diets (KDs) have been developed, namely classical K Read More

Background: An increasing amount of evidence suggests an association between epilepsy and multiple somatic and psychiatric conditions, which is more significant than in the general population. Furthermore, a bidirectional association has been established between epilepsy and several conditions, notably depression and suicide, cerebrovascular disease, stroke, dementia and migraine, which is best explained by the pres Read More

Background: Approximately one third of patients with epilepsy are refractory to medical treatment. Adverse effects associated with Anti-Epileptic Drugs (AEDs) are considered to affect quality of life often more than seizures themselves. Neuroimaging techniques, particularly Magnetic Resonance Imaging (MRI), have proven instrumental in clinical decision making in relation to epilepsy surgery, but may also provide furt Read More

Background: Epilepsy affects about 70 million people worldwide, nearly 90% of whom live in developing countries. Epilepsy is surrounded by myths and stigma in these countries. Discrimination and social stigmatization are difficult obstacles for patients to overcome. Knowledge, attitudes and practices towards epilepsy are often inadequate, even sometimes totally false and then dangerous. Methods: The goal was to present th Read More

Background: Although epilepsy surgery is a recognized treatment option for drug-resistant epilepsies since several decades, the management of antiepileptic drugs (AEDs) after successful surgery still remains one of the most difficult and unsolved therapeutic challenges. Indeed, no systematic controlled trials have been specifically conducted so far and no consensus or standardized guidelines regarding postsurgical drug discon Read More

Background. Growing evidence indicates that pharmacogenomics will positively impact treatment for patients with epilepsy in the near future, leading to the implementation of a precision-based use of antiepileptic drug (AED) therapy, thereby providing a cornerstone for precision medicine. Objective: In this review, we briefly summarize the studies of pharmacogenomics in epilepsy, recent advances, and how it may progress Read More