Epilepsy: Indian perspective

Santhosh, Nandanavana Subbareddy; Sinha, Sanjib; Satishchandra, Parthasarathy

doi:10.4103/0972-2327.128643

Cited by 76 publications

(51 citation statements)

References 84 publications

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“…The lack of sufficient data related to AEDs, poverty, cultural viewpoints, debates, poor health communications, and scarcity of skilled experts contribute to the management space (37). Adverse drug reactions such as hepatotoxicity, mitochondrial toxicity, hyperammonemic encephalopathy, hypersensitivity syndrome reactions, neurological toxicity, teratogenicity, metabolic and endocrine adverse events have been reported in relation to valproic acid (7,38,39).…”

Section: Discussionmentioning

confidence: 99%

Evidence-Based Pharmacotherapy of Epilepsy

2014

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Background: Due to the narrow therapeutic window of the AEDs prescription, their side effects and efficacy are the most important items that should be considered in epileptic patients. Objectives: This study aimed to investigate evidence-based pharmacotherapy in epileptic patients. Patients and Methods: Data were collected Cross-sectionally from patients (n = 24) registered at Kashani Epilepsy Ward in Isfahan. Demographic, clinical, hematology and biochemical data were recorded in d-base and analyzed using SPSS application for windows. Results: The frequency of polypharmacy was 79% in which 50% of epileptic patients received 3 to 4 AEDs. The onset of seizure was under 16 years old in 70% of patients. Fourteen varieties of AEDs were used, among them valproic acid (Depakote) was the most administered drugs. Prescriptions of two patients consisted of 4 and 6 AEDs: patient with code No. 575 (carbamazepine, topiramate, clobasam, lamotrigine) and another one with code No. 587 (oxcarbamazepine, phenytoin, gabapentin, valproic acid, clonazepam, lamotrigine). Red blood cell counts, hemoglobin and hematocrit in patients under more than one drug treatment were significantly lower than patients with AED monotherapy. Conclusions: AEDs are well-recognized to control seizure attacks. In clinical practice, the older generation of AEDs such as carbamazepine (CBZ), valporic acid (VPA), phenytoin (PHT), topiramate (TOP) and lamotrigine (LAMO) might need monitoring serum levels. Nonrational polypharmacy in terms of simultaneous using of both AEDs inducer and inhibitor could cause sedation, dizziness, and cognitive adverse effects. Further studies are needed to confirm these associations. Finally, to avoid polypharmacy that could arise side effects, a sufficient intervention for each AED to decide on its continuation, interruption or the number of drugs should be attempted. Combinations based on CBZ + VP, VP + TOP, CBZ + TOP, VP + LAMO, and TOP + LAMO could cause pharmacokinetic interactions.

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Section: Discussionmentioning

confidence: 99%

Evidence-Based Pharmacotherapy of Epilepsy

2014

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“…1 It has been estimated that approximately 80% of them are in developing countries. 2 The overall prevalence of epilepsy in India is reported as 1%, which is slightly higher in the rural areas (1.9%). 2 Approximately two-thirds of the patients experience simple or complex partial (focal) seizures, whereas the remaining one-third experience generalized seizures.…”

Section: Introductionmentioning

confidence: 99%

“… 2 The overall prevalence of epilepsy in India is reported as 1%, which is slightly higher in the rural areas (1.9%). 2 Approximately two-thirds of the patients experience simple or complex partial (focal) seizures, whereas the remaining one-third experience generalized seizures. 3 Uncontrolled seizures can lead to a wide variety of consequences, including shortened lifespan, neuronal death, excessive bodily injury, physiological dysfunction, neuropsychological and psychiatric impairment, and social disability.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of safety and efficacy of zonisamide in adult patients with partial, generalized, and combined seizures: an open labeled, noncomparative, observational Indian study

Dash

Ravat

Srinivasan³

et al. 2016

TCRM

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A prospective, multicentric, noncomparative open-label observational study was conducted to evaluate the safety and efficacy zonisamide in Indian adult patients for the treatment of partial, generalized, or combined seizures. A total of 655 adult patients with partial, generalized, or combined seizures from 30 centers across India were recruited after initial screening. Patients received 100 mg zonisamide as initiating dose as monotherapy/adjunctive therapy for 24 weeks, with titration of 100 mg every 2 weeks if required. Adverse events, responder rates, and seizure freedom were observed every 4 weeks. Efficacy and safety were also assessed using Clinicians Global Assessment of Response to Therapy and Patients Global Assessment of Tolerability to Therapy, respectively. Follow-up was conducted for a period of 24 weeks after treatment initiation. A total of 655 patients were enrolled and received the treatment and 563 completed the evaluation phase. A total of 20.92% of patients received zonisamide as monotherapy or alternative monotherapy and 59.85% patients received zonisamide as first adjunctive therapy. Compared with baseline, 41.22% of patients achieved seizure freedom and 78.6% as responder rate at the end of 24 week study. Most commonly reported adverse events were loss of appetite, weight loss, sedation, and dizziness, but discontinuation due to adverse events of drug was seen in 0.92% of patients. This open label real-world study suggests that zonisamide is an effective and well-tolerated antiepileptic drug in Indian adults for treatment of partial, generalized as well as combined seizures type. No new safety signals were observed.

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“…[1] More than 10 million people suffer from this disease in India. [2] The disease is characterized by brief episodes of seizures and excessive EEG discharge generally associated with the loss of consciousness with body movements (convulsions). [3] Epileptic seizures often cause temporary mutilation of perception, leaving the person at threat of physical damage.…”

Section: Introductionmentioning

confidence: 99%

Preliminary Screening of a Classical Ayurvedic Formulation for Anticonvulsant Activity

et al. 2016

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Background:Epilepsy is a serious and complex central nervous system disorder associated with recurrent episodes of convulsive seizures due to the imbalance between excitatory (glutamatergic) and inhibitory (GABAergic) neurotransmitters level in the brain. The available treatments are neither competent to control the seizures nor prevent progress of disease. Since ages, Herbal medicines have remained important sources of medicines in many parts of world which is evidenced through their uses in traditional systems of medicine i.e. Ayurveda, Siddha, Unani, Homeopathy and Chinese etc.Aim:A polyherbal formulation (containing Terminalia chebula Retz., Asparagus racemosus Willd., Embelia ribes Burm. F, Acorus calamus L., Tinospora cordifolia (Willd.) Miers, Convolvulus pluricaulis Choisy, Saussurea lappa C.B.Clarke, Achyranthes aspera L.) is mentioned in Ayurvedic classics Bhaiṣajya Ratnāvali. The aim of the study was to evaluate the anticonvulsant activity of the formulation in Maximum electroshock and Pentylenetetrazole induced convulsions in rats.Materials and Methods:In the present study, a polyherbal formulation was developed as directed by classical text and evaluated for the anticonvulsant activity using Maximal Electroshock Shock (MES) and Pentylenetetrazole (PTZ) induced convulsions in rats. Statistical comparison was done by one way ANOVA followed by the Tukey's multiple comparison test.Results:The obtained results showed that the PHF had a protective role on epilepsy. Treatment with PHF significantly improves antioxidant enzymes activities of superoxide dismutase (SOD) and glutathione (GSH) levels significantly as compared to controls. PHF also significantly decreased malonaldialdehyde (MDA) levels in the brain. Moreover, it also attenuated the PTZ-induced increase in the activity of GABA-T in the rat brain.Conclusion:These findings suggest that PHF might have possible efficacy in the treatment of epilepsy.

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Epilepsy: Indian perspective

Cited by 76 publications

References 84 publications

Evidence-Based Pharmacotherapy of Epilepsy

Evidence-Based Pharmacotherapy of Epilepsy

Evaluation of safety and efficacy of zonisamide in adult patients with partial, generalized, and combined seizures: an open labeled, noncomparative, observational Indian study

Preliminary Screening of a Classical Ayurvedic Formulation for Anticonvulsant Activity

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