- |||||||||| midazolam hydrochloride / Generic mfg.
[VIRTUAL] Status Epilepticus in the Setting of COVID-19 Infection () - Oct 21, 2021 - Abstract #ANA2021ANA_202;
While the exact mechanism of how COVID19 causes SE is currently unknown, COVID-19 has been associated with various neurological conditions. Our patient developed a convulsive SE originating focally from the right hemisphere associated with severe COVID-19 infection.
- |||||||||| ketamine / Generic mfg., lorazepam / Generic mfg.
[VIRTUAL] Testing the Salzburg Criteria in Cefepime Induced Non-Convulsive Status Epilepticus () - Oct 21, 2021 - Abstract #ANA2021ANA_201;
Initial attempt to classify the pattern as ictal using clinical and EEG improvement from IV anti-seizure medications in this case failed, but both EEG and clinical improvement was seen after 24 hours of IV ketamine infusion. Our report highlights need to quantify the time interval that should be used to define NCSE in the Salzburg criteria through the trial of IV anti-seizure medication.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo, Cytovene (ganciclovir) / Roche
[VIRTUAL] HYPERAMMONEMIA SYNDROME AFTER LUNG TRANSPLANTATION: A CALL FOR BROADENING OF THE PERI-OPERATIVE ANTIMICROBIAL COVERAGE () - Oct 13, 2021 - Abstract #CHEST2021CHEST_2457;
Furthermore, she developed generalized tonic clonic seizures on POD 17 requiring initiation of levetiracetam and lacosamide...Patient was transitioned to dual therapy treatment with azithromycin and levofloxacin given the severity of illness and risk of resistance... We, therefore, recommend including antibiotics with efficacy against atypical infections in the post-operative period among all LT patients.
- |||||||||| lorazepam / Generic mfg., midazolam hydrochloride / Generic mfg.
[VIRTUAL] COVID-19-ASSOCIATED LEUKOENCEPHALOPATHY PRESENTING AS NEW ONSET REFRACTORY STATUS EPILEPTICUS () - Oct 13, 2021 - Abstract #CHEST2021CHEST_705;
CASE PRESENTATION: A 50-year-old Caucasian woman with a past medical history significant for chronic lymphocytic leukemia (CLL) for which she was on umbralisib and venetoclax, was admitted with COVID-19 infection...After several courses of antibiotics, her septic shock was successfully treated with meropenem...Therapy with lorazepam, four doses of 4mg IV, propofol infusion, phosphenytoin and levetiracetam failed to abort the seizures...Lacosamide and midazolam infusion were then sequentially added and were successful in terminating the seizures... This case is unique in that this patient in addition to the depressed mental status typically seen in COVID-19-positive patients who develop leukoencephalopathy, developed new-onset refractory status epilepticus as well.
- |||||||||| lorazepam / Generic mfg.
[VIRTUAL] ACUTE ACQUIRED MACROGLOSSIA IN REFRACTORY STATUS EPILEPTICUS PATIENT () - Oct 13, 2021 - Abstract #CHEST2021CHEST_545;
After admission, she had multiple seizure episodes responding to Lorazepam...She was started on Levetiracetam but was found to be in non-convulsive status epilepticus on continuous EEG monitoring...Lacosamide was added followed by sodium valproate and fosphenytoin without any improvement... In conclusion, in acute critically ill patients with acute acquired macroglossia, cessation of offending agents, with airway protection is cornerstone.
- |||||||||| gabapentin / Generic mfg., carbamazepine / Generic mfg.
Journal: Inhibitory effect of anti-seizure medications on ionotropic glutamate receptors: special focus on AMPA receptor subunits. (Pubmed Central) - Oct 13, 2021
Only a few ASMs evaluated in this study showed direct interaction with ionotropic glutamate receptors. Perampanel is the only ASM that had a potent inhibitory effect on all AMPA receptor subtypes, but did not inhibit NMDA or kainate receptor subunits; while phenobarbital inhibited GluA2(R), and carbamazepine and lamotrigine inhibited the NMDA receptor at high concentration ranges.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
Preclinical, Journal, IO biomarker: Lacosamide improves biochemical, genotoxic, and mitochondrial parameters after PTZ-kindling model in mice. (Pubmed Central) - Oct 10, 2021
Male mice were treated on alternative days for a period of 11 days with LCM (20, 30, or 40 mg/kg), saline, or diazepam (2 mg/kg), before PTZ administration (50 mg/kg)...The dose of 20 mg/kg increased COX-2 expression while the highest dose used, 40 mg/kg, was able to reduce this expression when compared to the group treated with LCM 20 mg/kg. Although LCM did not produce the antiepileptogenic effect in vivo, it showed the neuroprotective effect against oxidative stress, bioenergetic dysfunction, and DNA damage induced by the repeated PTZ administration.
- |||||||||| sertraline / Generic mfg.
Clinical, Journal: Development and validation of an LC-MS/MS method for relevant drugs in epilepsy patients using dried blood spots. (Pubmed Central) - Sep 30, 2021
Proof-of-concept of the developed method was obtained by the analysis of dried blood spots from 282 authentic left-over EDTA blood samples, which were compared with the corresponding serum concentrations. Altogether, the results show a dependency on the blood/plasma ratios of the respective analytes, so that for drugs with blood-to-plasma ratios close to one, e.g. lacosamide, levetiracetam, brivaracetam, and sertraline, a good accordance was observed.
- |||||||||| gabapentin / Generic mfg., carbamazepine / Generic mfg.
Review, Journal, Adverse events: Pitch perception modification due to antiepileptics: A literature and pharmacovigilance databases review (Pubmed Central) - Sep 19, 2021
Pitch perception modifications are among the little-known adverse effects observed with antiepileptics, mainly affecting patients treated with carbamazepine (CBZ)...In the French pharmacovigilance database, only one other case of pitch perception modification under CBZ was recorded (no cases were found with oxcarbazepine, lacosamide, sodium valproate, lamotrigine, levetiracetam, phenobarbital, phenytoin, primidone, ethosuximide, vigabatrine, felbamate, gabapentin, tiagabine and topiramate)...A rapid onset after the introduction of treatment, a complete resolution of symptoms, in most cases upon discontinuation of treatment, is observed, with no sequelae reported. Due to the impact on quality of life, especially in patients whose profession is related to music, knowledge of this adverse event seems important to evoke this diagnosis.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
Journal: Impact of carbamazepine and lacosamide on serum lipid levels. (Pubmed Central) - Sep 19, 2021
Due to the impact on quality of life, especially in patients whose profession is related to music, knowledge of this adverse event seems important to evoke this diagnosis. No abstract available
- |||||||||| methylphenidate tablet / Generic mfg.
Clinical, Review, Journal: Drugs for patients with epilepsy and excessive daytime sleepiness. (Pubmed Central) - Sep 18, 2021
Several meta-analyses suggested that lamotrigine, lacosamide, and perhaps eslicarbazepine are less sedative than other traditional and new ASMs and, in patients prone to somnolence, might be preferred over ASMs with more sedative properties...Methylphenidate, modafinil, armodafinil, pitolisant, and solriamfetol are authorized for use in ADHD and EDS in patients with narcolepsy and some of them also in OSAS...The risks of cardiovascular events and psychiatric symptoms should be carefully evaluated as such disorders can coexist with epilepsy and be triggered by these agents. Finally, combination of psychostimulants with ASMs may be associated with several pharmacokinetic drug-drug interactions.
- |||||||||| Retrospective data, Journal: Medical treatment of SUNCT and SUNA: a prospective open-label study including single-arm meta-analysis. (Pubmed Central) - Sep 16, 2021
The response to sodium channel blockers indicates a therapeutic overlap with trigeminal neuralgia, suggesting that sodium channels dysfunction may be a key pathophysiological hallmark in these disorders. Furthermore, the therapeutic similarities between SUNCT and SUNA further support the hypothesis that these conditions are variants of the same disorder.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
Retrospective data, Journal, Monotherapy: Lacosamide as first add-on or conversion monotherapy: A retrospective real-life study. (Pubmed Central) - Sep 16, 2021
Furthermore, the therapeutic similarities between SUNCT and SUNA further support the hypothesis that these conditions are variants of the same disorder. This real-life study confirms that LCM is an effective and well tolerated treatment option as first add-on or conversion monotherapy for focal seizures.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
Thymoma Associated with Autoimmune Encephalitis and Subsequent Myasthenia Gravis. () - Sep 10, 2021 - Abstract #NCS2021NCS_286;
Conclusions Thymoma associated paraneoplastic syndromes of multifocal cortical encephalitis and subsequent myasthenia gravis may present in one person. Thymectomy and aggressive immunotherapy are required to achieve clinical improvement.
- |||||||||| ketamine / Generic mfg.
Covid-19 Associated New-onset Refractory Status Epilepticus (NORSE): A Case Report () - Sep 10, 2021 - Abstract #NCS2021NCS_237;
Anti-epileptic drugs were escalated to lacosamide, phenytoin, midazolam infusion, propofol, and eventually ketamine and pentobarbital infusion...Patient was treated with 5 days of solumedrol and IVIG...Conclusions COVID-19 is thought to enter the central nervous system through the olfactory bulb, which may result in neurological manifestations including NORSE. Although our patient developed subarachnoid hemorrhage, possibly from anticoagulation, the refractory nature of his seizures appear to be out of proportion to the extent of subarachnoid hemorrhage demonstrated on neuroimaging, leading us to conclude that NORSE occurred due to COVID-19 infection.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
Journal: Buprenorphine may be effective for treatment of paramyotonia congenita. (Pubmed Central) - Sep 10, 2021
The exercise test may be useful for quantitative assessment of treatment response. Further studies on a larger number of patients, under carefully controlled conditions, should be considered to address effectiveness and long-term tolerability of this possible therapeutic option.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
Giant Enigma: A Case Report of Post-infantile Giant Cell Hepatitis Presenting With Seizures (Shoreline Exhibit Hall) - Sep 8, 2021 - Abstract #ACG2021ACG_3011;
Once transferred, the vEEG revealed seizures, which were controlled with levetiracetam and phenytoin, and the patient was successfully extubated...High-dose methylprednisolone, mycophenolate mofetil, and lacosamide were started, leading to resolution of the patient’s transaminitis, seizures, and return to normal mental status...This presentation of seizures and altered mental status has been a rare complication of autoimmune hepatitis, but has not been documented in those with PIGCH. The resolution of symptoms and transaminitis once corticosteroids were introduced shows that higher dose steroids may be necessary for treatment.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
Journal: Inhibition of neuronal Na currents by lacosamide: Differential binding affinity and kinetics to different inactivated states. (Pubmed Central) - Aug 29, 2021
Consistent with these biophysical characters, we further demonstrated that lacosamide is much more effective against repetitive burst discharges with interburst intervals at -60 mV than -80 mV. With preponderant binding to the slow inactivation state in therapeutic concentrations and thus less propensity to affect normal discharges, lacosamide could be a drug of choice for seizure discharges characterized by relatively depolarized interburst intervals, during which more slow inactivated states could be generated and more binding of lacosamide would ensue.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
Journal: Time course evaluation of lacosamide alone and in polypharmacy on behavioral manifestations and oxidative stress in lithium-pilocarpine-induced model. (Pubmed Central) - Aug 26, 2021
Here we investigated the impact of lacosamide alone and in combination with other drugs (pregabalin, piracetam and scopolamine) on spontaneous recurrent seizures (SRSs) and behavioral parameters during the time frame of 6 weeks after SE...Furthermore, superoxide dismutase (SOD) and glutathione peroxidase (GPx) levels in the L/P group were significantly (P < 0.05) improved. Overall, our findings support the use of a combination of drugs (L/P and L/Pi) in lithium-pilocarpine model which remarkably ameliorated SRSs, reduced anxiety-related behaviors, retention of spatial/reference memory and lowered oxidative stress in a time-course evaluation 6 weeks post- SE insult.
- |||||||||| lacosamide / Generic mfg.
Trial completion date, Trial primary completion date: The Effect of Lacosamide in Peripheral Neuropathic Pain (clinicaltrials.gov) - Aug 18, 2021
P2, N=108, Recruiting,
Trial completion date: Oct 2021 --> Mar 2022 | Trial primary completion date: Aug 2021 --> Jan 2022 Trial completion date: May 2021 --> Oct 2022 | Trial primary completion date: May 2021 --> Oct 2022
- |||||||||| trazodone ER / Generic mfg., lorazepam / Generic mfg.
Clinical, Journal: Benzodiazepine Withdrawal Catatonia, Delirium, and Seizures in a Patient With Schizoaffective Disorder. (Pubmed Central) - Aug 15, 2021
He was taking olanzapine, venlafaxine, and trazodone for schizoaffective disorder...Seizures stopped with levetiracetam, lacosamide, and propofol on day 4...As with prior observations, the patient's catatonia was more sensitive to benzodiazepine withdrawal and treatment than his seizures. The efficacy of benzodiazepines in aborting catatonia, seizures, and mixed delirium-catatonia syndromes suggests a key pathogenetic role of abnormal GABA neurotransmission in these brain disorders.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
PK/PD data, Journal: Change in the pharmacokinetics of lacosamide before, during, and after pregnancy. (Pubmed Central) - Aug 11, 2021
The efficacy of benzodiazepines in aborting catatonia, seizures, and mixed delirium-catatonia syndromes suggests a key pathogenetic role of abnormal GABA neurotransmission in these brain disorders. No abstract available
- |||||||||| pregabalin / Generic mfg., gabapentin / Generic mfg.
[VIRTUAL] FORCED NORMALIZATION IN EPILEPSY: MYTH OR REALITY? (Topic A) - Aug 6, 2021 - Abstract #WCN2021WCN_431;
He observed that in patients with intractable epilepsy exposed to the then new drug, ethosuximide, the seizures became controlled, but there emerged a range of psychiatric symptoms...Forced Normalization has been described in the last two decades with novel AEDs, levetiracetam, lacosamide; however, the risk of alternative psychosis and forced normalization seems to be particularly low with the new anticonvulsants oxcarbazepine, eslicarbazepine, gabapentin and pregabalin...Yet, very little by way of prospective research or clinical trial attention as been paid to this condition, which indeed could help one distinguish, perhaps, strong from weak AEDs. In this talk we will examine the myth and reality of Forced Normalization in epilepsy, the contemporary relevance of the phenomenon in drug development and clinical practice, and indeed its future application.
- |||||||||| Fycompa (perampanel) / Eisai
Journal, HEOR: Value of Perampanel as Adjunctive Treatment for Partial-Onset Seizures in Epilepsy: Cost-Effectiveness and Budget Impact Analysis. (Pubmed Central) - Aug 5, 2021
Budget impact analysis indicates that after inclusion of PER in the NRDL, the incremental budget would be $1.28, $2.83, and $4.56 million from 2021 to 2023, respectively, but covering more eligible epileptic patients in the same time (1,918, 4,287, and 8,983, respectively). PER (8 or 4 mg/day) is of relatively high value as an add-on therapeutic regimen for partial-onset seizures in China because of its dominate advantage of cost-effectiveness over LCM and acceptable budget impact.
- |||||||||| pregabalin / Generic mfg.
Observational data, Journal: Seizure freedom and plasma levels of newer generation antiseizure medications. (Pubmed Central) - Jul 21, 2021
Determination of physicochemical descriptors showed that C-11 meets the drug-likeness requirements resulting from Lipinski and Veber's rules and prediction of gastrointestinal absorption and brain penetration, which is extremely important for the CNS-active compounds. Efficacy of newer generation ASMs seems to be reached at the lower part or at times even below the reference ranges in drug responsive patients; this could inform regarding titrations of these treatments.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
Clinical, Journal: Myoclonic dystonia (DYT11) responsive to lacosamide: a case report. (Pubmed Central) - Jul 18, 2021
Efficacy of newer generation ASMs seems to be reached at the lower part or at times even below the reference ranges in drug responsive patients; this could inform regarding titrations of these treatments. No abstract available
- |||||||||| pregabalin / Generic mfg., sirolimus / Generic mfg., gabapentin / Generic mfg.
Review, Journal: Interaction of cannabidiol with other antiseizure medications: A narrative review. (Pubmed Central) - Jul 14, 2021
The existing literature is limited for some ASMs by studies having relatively small cohorts. As increasing numbers of patients use cannabidiol, specialists need to monitor closely for interactions clinically and with blood levels when required.
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