- |||||||||| carbamazepine / Generic Mfg.
Journal: Effects of single and combined low concentrations of neuro-active drugs on Daphnia magna reproduction and transcriptomic responses. (Pubmed Central) - Dec 1, 2019
Functional transcriptomics analysis indicated that the four clusters shared major de-regulated signalling pathways implicated on energy, growth, reproduction, and neurologically- related processes, which may be responsible for the observed reproductive effects. Thus, our study showed additive effects at the transcriptional and physiological level and is providing a novel approach to the analysis of environmental relevant mixtures of neuro-active compounds.
- |||||||||| carbamazepine / Generic Mfg.
Journal: Occurrence and Fate of Micropollutants in Private Wastewater Treatment Facility (WTF) and Their Impact on Receiving Water. (Pubmed Central) - Dec 1, 2019
The dominant micropollutants in the influent of the STTs were caffeine (13,346 ng/L), acetaminophen (11,331 ng/L), ibuprofen (1440 ng/L), and naproxen (1313 ng/L), in agreement with the amounts produced annually in Korea...The removal efficiencies of the selected micropollutants at the STTs ranged from 12% (carbamazepine) to 88% (acetaminophen), lower than typical removal by sewage treatment plants (STPs)...The concentrations of selected micropollutants upstream of the receiving water were generally lower compared with those observed downstream, indicating that effluent from STTs was the main source. The per capita discharge loads of STTs and annual emissions rates (kg/year) from private wastewater treatment facilities were estimated for the selected micropollutants.
- |||||||||| carbamazepine / Generic mfg.
Effect of PRAX-330 on SCN2A Gain of Function Mutations (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_1382;
Here we used an automated electrophysiology platform to determine the effects of PRAX-330 and carbamazepine (CBZ) on two SCN2A gain-of-function mutations (R1626Q and M1879T) associated with EOEE...We observed that PRAX-330 can correct the voltage dependence of inactivation for two different GOF mutants more potently than CBZ, and uniquely exerted a UDB of peak current. Based on this in vitro investigation, we predict that PRAX-330 will exhibit potent anticonvulsant activity in the setting of SCN2A GOF mutations.
- |||||||||| carbamazepine / Generic mfg., Trileptal (oxcarbazepine) / Novartis
The Phenotype of KCNQ2 Epileptic Encephalopathy (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_1353;
Ohtahara syndrome with burst-suppression patterns on EEGs are characteristic. Seizures are well controlled with sodium channel blockers, regardless of type of mutations.
- |||||||||| carbamazepine / Generic mfg., Trileptal (oxcarbazepine) / Novartis
Antiepileptic Drug Use and Pregnancy Outcomes in African American Women with Epilepsy (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_1164;
The other AEDs used were oxcarbazepine (OXC) and phenytoin (PHT)...The only major congenital malformation (carbamazepine) in the cohort also occurred in an AA woman taking carbamazepine...Despite the overall safety profile of newer AEDs reported in national registries, our cohort of mostly AA WWE showed slightly more adverse pregnancy and fetal outcomes which could be due to the low use of pre-conception folic acid use and higher incidence of unplanned pregnancies. Medical provider and patient education is essential in planning pregnancies and prescribing folic acid as AA WWE may be exposed to slightly higher risks of complications in pregnancy than reported in existing national registries.
- |||||||||| pregabalin / Generic mfg., carbamazepine / Generic mfg., Trileptal (oxcarbazepine) / Novartis
Levetiracetam Versus Sodium Channel Blockers as First Prescribed Antiepileptic Drug: Data from the Human Epilepsy Project (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_1095;
Results 157 (59.5%) initiated levetiracetam (LEV), 49 (18.6%) lamotrigine (LTG), 21 (8%) oxcarbazepine (OXC), 11 (4.2%) phenytoin, 5 (1.9%) topiramate, 12 (4.5%) carbamazepine, (CBZ) 2 (0.8%) lacosamide, 5 (1.9%) valproic acid, 1 (0.4%) pregabalin, and 1 (0.4%) zonisamide.Of the 157 started on LEV, 63 (31.6%) remained on the drug in monotherapy, 76 (48%) switched to another AED, 12 (7.6%) added an AED in conjunction, and 6 (3.8%) ceased AED usage...By the end of the study, pts were receiving the following AEDs alone or in combination: LEV 36.0%, LTG 37.5%, CBZ 6.8%, OXC 17.0%, PHT 0.8%, topiramate 2.3%, lacosamide 7.2%, valproic acid 1.9%, zonisamide 4.9%, lorazepam 0.8%, clobazam 0.4%, clonazepam 0.4%...The likelihood of remaining on initial monotherapy was twice as high for a sodium channel blocker as for LEV in the first 2 years of treatment. (P=.001)
- |||||||||| carbamazepine / Generic mfg.
NaV1.6 Selective and NaV1.2/NaV1.6 Dual Inhibitors Reduce Action Potential Firing in Mouse Cortical Pyramidal Neurons While Sparing Inhibitory Interneuron Firing (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_970;
Voltage-gated sodium channel inhibitors, like carbamazepine, are effective anticonvulsant drugs...Conclustions Selectively targeting the specific sodium channel isoforms expressed in excitatory neurons, NaV1.2 and NaV1.6, enables selective reduction of action potential firing in those neurons, and prevents the simultaneous impairment of the activity of inhibitory interneurons. This profile provides a new, mechanistically differentiated, class of voltage-gated sodium channel inhibitors with the potential to provide improved seizure control and side effect profile for epilepsy patients.
- |||||||||| carbamazepine / Generic mfg., Trileptal (oxcarbazepine) / Novartis
Effect of Antiepileptic Drug Monotherapy on the Risk of Death in Patients with Poststroke Epilepsy (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_941;
The opposite applies for patients treated with VPA, who seem to have a higher risk of both cardiovascular and all-cause death compared to CBZ and LTG. The analyses are adjusted for several confounders, but further studies are needed to establish a causal relationship.
- |||||||||| carbamazepine / Generic mfg.
Functional Consequences of a Novel De Novo SCN2A Variant of Unknown Significance Associated with an Early-Onset Epilepsy (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_926;
The child became seizure free after an intravenous loading dose of fosphenytoin...After discovery of the SCN2A variant, the patient’s treatment was modified to carbamazepine with a resulting decrease in seizure frequency...We interpret these data as indicating a gain of channel function which is consistent with the pathogenesis of epilepsy and the observed clinical efficacy of the sodium channel blocking anticonvulsant drugs. Our findings further demonstrate the value of conducting functional analyses of SCN2A variants of unknown significance to establish pathogenicity and genotype-phenotype correlations.
- |||||||||| carbamazepine / Generic mfg., Trileptal (oxcarbazepine) / Novartis
Risk of Epileptic Spasms Induction by Voltage-Gated Sodium Channel Blockade (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_858;
Several case reports have suggested that voltage-gated sodium channel blockade by carbamazepine (CBZ) or oxcarbazepine (OXC) may induce epileptic spasms (Mutoh 1993; Veerapandiyan 2012)...Cox proportional hazards regression, with time-varying covariates to account for dynamic exposure to specific anti-seizure drugs, was used to determine whether time to onset of ES was associated with exposure to any voltage-gated sodium channel blocker, namely CBZ, OXC, lacosamide (LAC), and phenytoin (PHT)...However, these results should be interpreted in the context of the limitations of the study design-especially the lack of randomization. Further study is warranted.
- |||||||||| carbamazepine / Generic mfg.
Epilepsy Is Heterogeneous Within Chromosome 1p36 Deletions (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_754;
Conclustions Given the neurological heterogeneity, it is evident that the seizure management should be tailored to individual patients and their phenotype. As the realm of genetics grows, specific mutations will need to be identified and then therapies tailored towards individual genotypes for optimal epilepsy management.
- |||||||||| carbamazepine / Generic mfg.
Paradoxical Worsening of Frontal Lobe Seizures with Benzodiazepines (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_752;
Patient’s seizure medications were held, and on the third night, he was noted to have a cluster of seven nocturnal seizures prompting IV diazepam use for a total of 15mg.The patient continued to have seizures requiring additional BZDs, total of 12mg of IV lorazepam and 4mg of IV midazolam over the course of 7 – 8 hours...His ASDs were continued at home doses (brivaracetam 100mg TID, carbamazepine 600-400-400, and perampanel 18mg QHS)...At that point his clobazam was stopped and switched to zonisamide and his seizure frequency decreased to 0-1 per night...Conclustions Paradoxical worsening of frontal lobe seizures with benzodiazepine usage can occur. BZDs still remain the first line for acute seizure treatment, however additional precautions should be taken when used for sleep activated frontal lobe seizures.
- |||||||||| carbamazepine / Generic mfg.
Antiseizure Drug Response of Outbred Versus Inbred Mice in Pharmacoresistant Acute and Chronic Seizure Models (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_678;
Conclustions This work highlights strain-related differences in the potency of acutely administered ASDs in common mouse seizure models; both inbred (C57Bl/6) and outbred (CF-1) mouse strains are frequently used in the development of novel ASDs. It also highlights the dose-dependent impacts that pharmacologically-equivalent doses of ASDs can have upon quantifiable locomotor behavior beyond the TD50 alone.
- |||||||||| Briviact (brivaracetam) / UCB, carbamazepine / Generic mfg., Trileptal (oxcarbazepine) / Novartis
Real-World Study of Brivaracetam in the US: An Interim Analysis (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_653;
Three patients died during the study, but none were judged to be drug-related. Conclustions This interim analysis indicates that retention on BRV (a measure of effectiveness) at 3 and 6 months is similar between patients that had previously failed LEV, LTG, OXC, and CBZ.
- |||||||||| Fycompa (perampanel) / Eisai, carbamazepine / Generic mfg.
Effect of Concomitant Anti-Seizure Drugs During Adjunctive Perampanel Treatment in Pediatric Patients (Aged 4 to <12 Years): Post Hoc Analysis of Study 311 (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_647;
P3
For the most common concomitant ASDs these were: levetiracetam: 48.9% (22/45) and 55.6% (5/9); valproic acid: 39.6% (19/48) and 75.0% (3/4); clobazam: 52.5% (21/40) and 66.7% (4/6); lamotrigine: 42.9% (15/35) and 77.8% (7/9); topiramate: 54.5% (12/22) and 40.0% (2/5); and carbamazepine: 42.3% (11/26) and 0.0% (0/0), respectively. Conclustions These data suggest adjunctive perampanel is generally well tolerated and efficacious in pediatric patients (aged 4 to ˂12 years) with POS (with/without SGS) or PGTCS, irrespective of baseline ASD use.
- |||||||||| carbamazepine / Generic mfg.
Anti-Epileptic Drugs and Efficacy Against Focal to Bilateral Tonic-Clonic Seizures: A Systematic Review (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_642;
Conclustions In a landmark older study, control of convulsive seizures did not differ significantly between phenytoin, carbamazepine, phenobarbital and primidone, and in a second study they observed no significant difference between carbamazepine and valproate...At the moment, there are insufficient evidence to determine the superiority of any one AED over another for treatment of FBTCS. Worthy of mention is the fact that none of the studies we analyzed reported the reduction in FBTCS during sleep, which is especially relevant for the prevention of SUDEP.
- |||||||||| nicotine transdermal / SLA, carbamazepine / Generic mfg.
Remarkable Effect of Transdermal Nicotine in Children with CHRNA4-Related Autosomal Dominant Sleep-Related Hypermotor Epilepsy (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_429;
However, long-term effects of nicotine treatment in children are obscure, and the balance between benefit and risk should be carefully weighed.Nicotine appears to be a mechanistic treatment for this specific disorder, probably due to desensitization of the mutated receptors. This mode of precision therapy should be available to more patients with uncontrolled CHRNA4-related ADSHE after a careful genetic and clinical selection.
- |||||||||| lamotrigine liquid oral suspension / OWP Pharma, carbamazepine / Generic mfg., Trileptal (oxcarbazepine) / Novartis
Prevalence of Concurrent Prescriptions for Oral Anticoagulants and Antiepileptic Drugs Among People with Epilepsy Between 2010-2016 (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_341;
The OACs included warfarin, as well as those DOACs that received regulatory approval during the study time frame (dabigatran, rivaroxaban, apixaban, and edoxaban)...These findings highlight the clinical significance of advancing understanding of interactions between EI-AEDs and OACs, given their potential impact on as much as 7.17% of PWE. In particular, further research into proposed interactions with DOACs appears warranted in light of rapid uptake of this form of anticoagulation within the population with epilepsy.
- |||||||||| carbamazepine / Generic mfg.
Interactions Between Anticonvulsants and Novel Oral Anticoagulants: A Systematic Review (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_293;
Rationale Novel oral anticoagulant medications including dabigatran etexilate, rivaroxaban, apixaban and edoxaban provide safe and convenient alternative for the traditional anticoagulation with vitamin K antagonists and heparin derivatives...Carbamazepine, phenytoin, and phenobarbital were reported to interact with NOAC...These interaction lead to either decreased NAOC plasma levels or development of thrombotic events. Conclustions Providers should be familiar with potential clinically significant interactions between NOAC and anticonvulsants and be aware of the use of drug level measurements to manage patients receiving these agents.
- |||||||||| carbamazepine / Generic mfg.
Review of Sudden Unexpected Death in Epilepsy in a New Zealand Population: Post-Mortem and Toxicology Analysis (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_288;
Approximately half who took an AED were taking either Sodium Valproate or Carbamazepine...SUDEP cases are likely to be under-reported particularly in older population. Standardization of post-mortem documentation would increase the yield of this type of review and may eventually lead to interventions that reduce premature deaths in epilepsy populations.
- |||||||||| Fycompa (perampanel) / Eisai, carbamazepine / Generic mfg.
Use of Perampanel Without Therapeutic Drug Monitoring (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_284;
Perampanel is metabolized by the CYP3A4&5 system, and use of ASDs that are inducers this system can significantly reduce perampanel concentrations.1 Thus, the prediction of the appropriate dose is difficult and lack of the ability to use therapeutic drug monitoring to guide treatment may lengthen the duration of trial and error seen in this study. In the subject eventually needing 22 mg/day, the dose escalation may have been done more rapidly if it were known that the levels produced by the usual perampanel doses were low.
- |||||||||| tacrolimus / Generic mfg., methylprednisolone / Generic mfg., carbamazepine / Generic mfg.
Efficacy of Intensive Treatment for Intractable Seizures in a Case of Adult-Onset Rasmussen Syndrome (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_281;
We challenged cessation of ZNS, dose increase of CBZ and LTG, and addition of clobazam...Conclustions This case highlights the importance of intensive treatment including oral corticosteroid, T-cell inactivating drugs, IVIG, IVMP, VNS, and AEDs for seizure reduction in therapy of patients with adult-onset RS. Especially, in addition to basic immunotherapy, VNS along with the best-adjusted AEDs should be considered in progressive cases.
|
