Talk:Anticonvulsant

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Contents 1 Convulsant 2 Suggest We mention Lack of Medication Approval 3 Adding for finding of fact 4 Approval dates 5 Apoptosis

[edit] Convulsant

Is there an opposite to anti-convulsants ie a medicine that blocks or destroys GABA or by any other way?

1) Not all anticonvulsants are GABA-active. Some of them, yes.

I know that's why I put "or by any other way"

2) Yes, there are compounds, that exhibit GABA-receptor-blockage. Commonly, these substances are (if they penetrate the brain-blood barier) convulsants, or convulsive poisons. Examples are some diene polychlorinated insecticides (dieldrin, endrin, endosulfan and the like) and picrotoxin, as well as other "cage convulsants", like tetramine, for example.--Spiperon 22:01, 23 October 2006 (UTC)

Thanks.

[edit] Suggest We mention Lack of Medication Approval

I think its worth mentioning that MANY anti-seizure DRUGS have never been APPROVED FOR CHILD USE by the (FDA) Food and Drug Administration in the United States.muncher 15:51, 23 October 2006 (UTC)

The licensing situation for children is complex and not unique to anticonvulsants. "One recent estimate was that 75 of the 80 medicines most commonly prescribed for newborns and infants were being prescribed off-label.".[1] Licencing for children often specify several components:

1. The age, for example: 2, 6, 10 years.
2. The seizure type, for example: generalised seizures.
3. The syndrome, for example: Lennox-gastaut syndrome.
4. Combination, for example: either as monotherapy or in-addition to an established drug (adjunctive usage).

The older drugs such as phenobarbital, ethosuximide and phenytoin are approved for children effectively by default (they were in use well before modern regulations). Here is the FDA approval status of some of the common modern drugs.

• Topamax (topiramate) Adjundictve treatment of partial seizures (also seizures in Lennox-Gastaut syndrome) in children 2 years and over.[2][3]. Also monotherapy of partial onset or primary generalized tonic-clonic seizures in children 10 years and over. [4]
• Tegretol (carbamazepine) First-line monotherapy for the treatment of partial, secondarily generalized, and generalized tonic-clonic seizures in children. [5]
• Trileptal (oxcarbazepine). Adjunctive and monotherapy for the treatment of partial seizures in children 4 years and over. [6][7]
• Gabitril (tiagabine). Adjunctive treatment of partial seizures in children 12 years and over.[8]
• Lamictal (lamotrigine). Adjunctive treatment of generalized seizures in Lennox-Gastaut syndrome.[9] Also adjunctive treatment of generalised tonic-clonic seizures in children 2 years and over. [10]
• Neurontin (gabapentin). Adjunctive treatment of partial seizures in children 3 years and over.[11]
• Keppra (levetiracetam). Adjuntive treatment of partial seizures in children 4 years and over.[12]
• Depakote ER (divalproex sodium extended-release). Adjunctive and monotherapy for the treatment of partial seizures in children 10 years and above.[13]

There is a wider choice of licensed drugs for children in the UK.[14] [15].

There remains a shortage of approved medicines for infants (under 2 years). Getting approval for monotherapy is hard, hence adjunctive therapy is established first. If enough off-licence usage is occurring, there is little incentive on the manufacturer to fund trials to widen the licence. What is interesting is that no epilepsy drugs have ever been compared against placebo (largely for ethical reasons) and that, within its indications, no epilepsy drug has ever been shown to be significantly better than any other (older) drug. Some may, however, be better tolerated.[16]

Perhaps some of this information could be added to the article. Colin°^Talk 18:40, 23 October 2006 (UTC)

[edit] Adding for finding of fact

Jean P. Davis M.D., and H.H. Ramsey, M.D.

The demonstration of anticonvulsant activity of the tetrahydrocannabinol (THC) cogeners by laboratory tests (Loewe and Goodman, Federation Proc. 6:352, 1947) prompted clinical trial in five institutionalized epileptic children. All of them had symptomatic grand mal epilepsy with retardation; three has cerebral palsy in addition. EEG tracings were grossly abnormal in the entire group; three has focal seizure activity. Their attacks had been inadequately controlled on 0.13 gm. of Phenobarbital daily, combined with 0.3 gm. of Dilantin per day in two of the patients, and in a third, with 0.2 gm. of Mesantoin daily.

Two isomeric 3(1,2-dimethyl heptyl) homologs of THC were tested, numbers 122 and 125A, with ataxia potencies 50 and 8 times, respectively, that of natural Marijuana principles. Number 122 was given to 2 patients for 3 weeks and to 3 patients for 7 weeks. 3 responded at least as well to previous therapy; the 4th became almost completely and the 5th entirely seizure free. One patient transferred to 125A after 3 weeks, had prompt exacerbation of seizures during the ensuing 4 weeks, despite dosages up to 4 mg. daily. The 2nd patient transferred to 125A was adequately controlled on this dosage, except for a brief period of paranoid behavior three and a half weeks later; similar episodes had occurred prior to cannabinol therapy. Other psychic disturbances or toxic reactions were not manifested during the periods of treatment. Blood counts were normal. The cannabinoids herein reported deserve further trial in non-institutionalized epileptics. Reprinted from Federation Proceedings, Federation of American Society for Experimental Biology, vol 8, 1949, p.284.

These proceedings demonstrate unequivocally the Anticonvulsant properties of cannabinods. This is not opinion but fact and is therefore "absolute and non-negotiable" in accordance with WP:NPOV. Adding cannabinoids. Alphaquad 22:05, 19 March 2007 (UTC)

Tetrahydrocannabinol is not professionally used as an anticonvulsant. It (or related compounds) are being researched as such, along with thousands of other chemicals. This article should not mention all drugs that have some anticonvulsant effect - it would be uselessly long. Colin°^Talk 22:08, 19 March 2007 (UTC)

Length is not an issue for a single entry. Your persistence shows a biased opinion against this one item and is contrary wiki standards —The preceding unsigned comment was added by Alphaquad (talk • contribs) 22:17, 19 March 2007 (UTC).

[edit] Approval dates

Therapeutic drug monitoring in epilepsy by PN Patsalos, NSE. Has a slightly different set of dates for UK drug introductions. Colin°^Talk 21:49, 16 November 2007 (UTC)

[edit] Apoptosis

I am removing reference [2] and modifiying the sentence that antiepileptics cause cell death. This is wrong and taken out of context. It causes apoptosis in developing neurones, which means the effect is not seen in adult epileptics. I have read the reference and the group were looking at the effects of pregnant women taking AEDs by using postnatal rat models. The information is misleading to the extent that someone is asking about it in Yahoo answers. --Mubinchoudhury (talk) 21:41, 20 May 2008 (UTC)