Chronopharmacology of anti-convulsive therapy

Sriram Ramgopal; Sigride Thome-Souza; Tobias Loddenkemper

doi:10.1007/s11910-013-0339-2

Chronopharmacology of anti-convulsive therapy

Sriram Ramgopal, Sigride Thome-Souza, Tobias Loddenkemper^*

^*Corresponding author for this work

Pediatrics

Research output: Contribution to journal › Article › peer-review

37 Scopus citations

Abstract

Approximately one-third of patients with epilepsy continue to have seizures despite antiepileptic therapy. Many seizures occur in diurnal, sleep/wake, circadian, or even monthly patterns. The relationship between biomarkers and state changes is still being investigated, but early results suggest that some of these patterns may be related to endogenous circadian patterns whereas others may be related to wakefulness and sleep or both. Chronotherapy, the application of treatment at times of greatest seizure susceptibility, is a technique that may optimize seizure control in selected patients. It may be used in the form of differential dosing, as preparations designed to deliver sustained or pulsatile drug delivery or in the form of 'zeitgebers' that shift endogenous rhythms. Early trials in epilepsy suggest that chronopharma-cology may provide improved seizure control compared with conventional treatment in some patients. The present article reviews chronopharmacology in the treatment of epilepsy as well as future treatment avenues

Original language	English (US)
Article number	339
Journal	Current neurology and neuroscience reports
Volume	13
Issue number	4
DOIs	https://doi.org/10.1007/s11910-013-0339-2
State	Published - Apr 2013

Keywords

Chronopharmacodynamics
Chronopharmacokinetics
Chronopharmacology
Chronotherapy
Circadian pattern
Circadian rhythms
Closedloops
DLMO
Differential dosing
Dimlight melatonin onset
Diurnal patterns
Epilepsy
Lighttherapy
Melatonin
Pharmacodynamics
Pharmacokinetics
Seizure diary
Seizure patterns
Seizures
Seizuretracking
Suprachiasmatic nucleus

ASJC Scopus subject areas

Neuroscience(all)
Clinical Neurology

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10.1007/s11910-013-0339-2

Cite this

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title = "Chronopharmacology of anti-convulsive therapy",

abstract = "Approximately one-third of patients with epilepsy continue to have seizures despite antiepileptic therapy. Many seizures occur in diurnal, sleep/wake, circadian, or even monthly patterns. The relationship between biomarkers and state changes is still being investigated, but early results suggest that some of these patterns may be related to endogenous circadian patterns whereas others may be related to wakefulness and sleep or both. Chronotherapy, the application of treatment at times of greatest seizure susceptibility, is a technique that may optimize seizure control in selected patients. It may be used in the form of differential dosing, as preparations designed to deliver sustained or pulsatile drug delivery or in the form of 'zeitgebers' that shift endogenous rhythms. Early trials in epilepsy suggest that chronopharma-cology may provide improved seizure control compared with conventional treatment in some patients. The present article reviews chronopharmacology in the treatment of epilepsy as well as future treatment avenues",

keywords = "Chronopharmacodynamics, Chronopharmacokinetics, Chronopharmacology, Chronotherapy, Circadian pattern, Circadian rhythms, Closedloops, DLMO, Differential dosing, Dimlight melatonin onset, Diurnal patterns, Epilepsy, Lighttherapy, Melatonin, Pharmacodynamics, Pharmacokinetics, Seizure diary, Seizure patterns, Seizures, Seizuretracking, Suprachiasmatic nucleus",

author = "Sriram Ramgopal and Sigride Thome-Souza and Tobias Loddenkemper",

note = "Funding Information: Sriram Ramgopal declares no conflict of interest. Sigride Thome-Souza is a recipient of the CNPq scholarship (246205/2012-1) from the Brazilian government. Tobias Loddenkemper serves on the Laboratory Accreditation Board for Long Term (Epilepsy and Intensive Care Unit) Monitoring, on the Council of the American Clinical Neurophysiology Society, on the American Board of Clinical Neurophysiology, as an Associate Editor for Seizure, and performs video electroencephalogram long-term monitoring, electroencephalograms, and other electrophysiological studies at Boston Children's Hospital and bills for these procedures. He receives support from the National Institutes of Health/NINDS, a Career Development Fellowship Award from Harvard Medical School and Boston Children's Hospital, the Program for Quality and Safety at Boston Children's Hospital, the Payer Provider Quality Initiative, The Epilepsy Foundation of America (EF-213583 and EF-213882), the Center for Integration of Medicine and Innovative Technology, the Epilepsy Therapy Project, the American Epilepsy Society, Cure, the Pediatric Epilepsy Research Foundation, and investigator initiated research grants from Lundbeck and Eisai.",

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doi = "10.1007/s11910-013-0339-2",

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AU - Ramgopal, Sriram

AU - Thome-Souza, Sigride

AU - Loddenkemper, Tobias

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N2 - Approximately one-third of patients with epilepsy continue to have seizures despite antiepileptic therapy. Many seizures occur in diurnal, sleep/wake, circadian, or even monthly patterns. The relationship between biomarkers and state changes is still being investigated, but early results suggest that some of these patterns may be related to endogenous circadian patterns whereas others may be related to wakefulness and sleep or both. Chronotherapy, the application of treatment at times of greatest seizure susceptibility, is a technique that may optimize seizure control in selected patients. It may be used in the form of differential dosing, as preparations designed to deliver sustained or pulsatile drug delivery or in the form of 'zeitgebers' that shift endogenous rhythms. Early trials in epilepsy suggest that chronopharma-cology may provide improved seizure control compared with conventional treatment in some patients. The present article reviews chronopharmacology in the treatment of epilepsy as well as future treatment avenues

AB - Approximately one-third of patients with epilepsy continue to have seizures despite antiepileptic therapy. Many seizures occur in diurnal, sleep/wake, circadian, or even monthly patterns. The relationship between biomarkers and state changes is still being investigated, but early results suggest that some of these patterns may be related to endogenous circadian patterns whereas others may be related to wakefulness and sleep or both. Chronotherapy, the application of treatment at times of greatest seizure susceptibility, is a technique that may optimize seizure control in selected patients. It may be used in the form of differential dosing, as preparations designed to deliver sustained or pulsatile drug delivery or in the form of 'zeitgebers' that shift endogenous rhythms. Early trials in epilepsy suggest that chronopharma-cology may provide improved seizure control compared with conventional treatment in some patients. The present article reviews chronopharmacology in the treatment of epilepsy as well as future treatment avenues

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KW - Pharmacokinetics

KW - Seizure diary

KW - Seizure patterns

KW - Seizures

KW - Seizuretracking

KW - Suprachiasmatic nucleus

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ER -

Chronopharmacology of anti-convulsive therapy

Abstract

Keywords

ASJC Scopus subject areas

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