1 edition of Rational polypharmacy in the treatment of epilepsy found in the catalog.
Rational polypharmacy in the treatment of epilepsy
|Statement||B.J. Wilder, supplement editor.|
|Series||Neurology -- v.45, no.3, supplement 2 (March 1995), Neurology -- v. 45, 2.|
|Contributions||Wilder, B. J. 1929-|
|The Physical Object|
|Pagination||p. S1-S38 :|
|Number of Pages||38|
PHILADELPHIA—For patients whose epilepsy is refractory to monotherapy, rational polypharmacy may become a which factors should physicians deem most important when contemplating which treatments to add to the regimen? Josiane LaJoie, MD, Associate Professor of Neurology and Pediatrics at the New York University Langone Medical Center in New York City, . Several population-based studies and meta-analyses have found that suicide is an important contributor to the elevated mortality observed in epilepsy and that individuals with epilepsy have a higher risk of suicide, even when coexisting psychiatric disease, demographic differences, and socioeconomic factors were taken into account. 28,– 30 In.
The mission of the Epilepsy Foundation is to lead the fight to overcome the challenges of living with epilepsy and to accelerate therapies to stop seizures, find cures, and save lives. follow us Professional Place West, Suite , Landover, MD | Highly Commended at the British Medical Association Book Awards The Treatment of Epilepsy, fourth edition, is a comprehensive reference and clinical guide to the pharmacological, medical and surgical options available in the treatment of epilepsy.. The text is compiled by a group of internationally renowned editors and contributors and is now in full color and extensively illustrated.
Polypharmacy in the treatment of depression has an increasing trend. While % of depression patients received 3 or more drugs in s, in s the rate increased to % in an NIMH hospital (Frye et al., ).Although the exact share of rational polypharmacy could not be ascertained, evidence base for polypharmacy in depression management is satisfactory. Finally, the neurochemistry of epilepsy provides a basis for antiepileptic drug efficacy, rational drug design, and rational polypharmacy. However, we also provide an example where clinical experience with applying these lessons produced unexpected results, showing that the complexities of epilepsy and its treatment continues to intrigue and.
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INTERPRETATION: Thus, alteration of Cl−transport by bumetanide enables the anticonvulsant action of phenobarbital in immature brain. This is a mechanistic demonstration of rational anticonvulsant polypharmacy. The combination of these agents may comprise an effective therapy for early-life : Gregory C.
Mathews. Rational Polypharmacy (Epilepsy Research Supplement): Medicine & Health Science Books @ OCLC Number: Notes: Based on the proceedings of a symposium held in Washington, D.C., May 1, Description: pages S1-S illustrations ; 28 cm.
SEATTLE —Rational polypharmacy with antiepileptic drugs (AEDs) may be beneficial if monotherapy fails in patients with epilepsy, according to Tracy Glauser, MD. In the s, a number of epileptologists began to argue that single drug therapy was desirable in the treatment of epilepsy and this has become the accepted policy when initiating therapy.
About 75% of patients treated in this way will achieve remission with a minimum of adverse drug reactions. However, rationally chosen drug combinations (rational polypharmacy), including drugs that are not already clinically used for epilepsy therapy, are as yet not routinely used in treatment of SE, although they are actively debated since several years (Wasterlain and Chen,Pitkänen and Wasterlain,Rossetti and Lowenstein, ).
The. Rational combination therapy is not new. It is the norm in many other areas of therapeutics such as Parkinsonism, hyper- tension, asthma and antibiotic therapy. It is common even in epilepsy therapy. Many prac- titioners know that while they may aim for monotherapy, around 50% of their patients will be on two drugs or more.
A practical reference to the medical and surgical treatment of epilepsy. The third edition of The Treatment of Epilepsy has been thoroughly updated. It is a reference work, but has a strong practical bias, and is designed to assist neurologists, neurosurgeons and other clinicians at all levels who are involved in the treatment of patients with epilepsy.
Children's Book. Books; OCD Books for Children; Chronic Conditions. Autoimmune Disorders; Substance Use Treatment and Indigenous communities; SUD & Incarceration/Reentry; Rational Polypharmacy Guidelines.
Deprescribing Guidelines and Algorithms https. Epilepsy is the tendency to have recurrent seizures unprovoked by systemic or acute neurologic insults.
(Slide 2) Antiepileptic drugs (AEDs) are those which decrease the frequency and/or severity of seizures in people with epilepsy. The older term, anticonvulsant drug, is still sometimes used as a synonym for AED, but is less accurate because many seizures do not involve convulsive movements.
Polypharmacy in the treatment of depression has an increasing trend. While % of depression patients received 3 or more drugs in s, in s the rate increased to % in an NIMH. Abstract Rational polypharmacy of antiepileptic drugs is one of the treatment strategies for refractory epilepsy.
To investigate whether it may be rational to combine carbamazepine (CBZ) and valproate (VPA), we tested both the anti-convulsant effect and the toxicity of combinations of CBZ and VPA in different dose proportions.
Summary Monotherapy has been considered the gold standard for drug treatment of epilepsy. However, there is renewed interest in polytherapy because of the advent of new drugs with fewer drug interactions and novel mechanisms of action, and the realization that most patients with refractory epilepsy are eventually treated with drug combinations.
All patients with refractory epilepsy should be informed of the risk of sudden unexpected death in epilepsy and appropriate precautions taken. Even with the contribution from experimental combination studies, the issue of rational polypharmacy for epilepsy remains largely unresolved.
Rational polypharmacy should thus be implemented with careful delineation of the prior course of illness (typically using life chart methodology) and targeted treatment outcomes titrated against side effects, using sequential clinical trials in individual patients who have not adequately responded to monotherapy.
Given the possibility of problematic drug interactions in any polypharmacy, whether rational or irrational, it can never be approached with too cavalier an attitude. As we learn more about the cytochrome P system and its substrates, inducers, and inhibitors, the best ways to avoid problems are to refrain from polypharmacy when one can and.
The synergy seems therefore to be specific to LEV, and the combination LEV/mGlu2 PAM has the potential to result in a rational polypharmacy approach to treat patients with refractory epilepsy. The concept of rational polypharmacy is more scientifically developed in the treatment of Parkinson’s disease, but neurologists also can apply it to essential tremor.
Rational polypharmacy entails using several medications with distinct mechanisms of action to enable greater functional improvement. Key topics include: rational polypharmacy, receptor binding targets, drug interactions, preclinical and clinical investigations in this field, dosing regimens, multiple medication use in forensic psychiatry, a naturalistic trial, adjunctive strategies, and multiple medication use for the treatment.
A major challenge facing epilepsy treatment is the effective delivery of AEDs across the BBB. The rationale for this mini-review stems from the urgent need to address the issue of CNS drug delivery in view of recent contradictory findings and the continuous debate on the role of drug transporters in determining the refractory phenotype.
Rational polypharmacy is in its earliest stages of development and will require substantial additional development to realize its full potential.
Indeed, despite the powerful appeal of the concept, clinical proof is not yet available that RP is superior to monotherapy. Important questions need to be addressed: 1.Summary: Monotherapy as a treatment concept in epilepsy is now being challenged by "rational polypharmacy", based on the theory that two or more anti-epileptic agents with different mechanisms of action may be more beneficial.
This volume addresses areas in which monotherapy may be more rational.mechanisms of action if more rational approaches toward both clinical application and research are to be adopted. An important example in this regard is the concept of rational polypharmacy for patients with epilepsy who are refractory to monotherapy.
This review summarizes our current understanding of the molecular.