Antiepileptic drugs and migraine

Rogawski, Michael A.

doi:10.1093/med/9780199552764.003.0020

Cited by 11 publications

(10 citation statements)

References 150 publications

(130 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All patients, except one, showed an increase of functional connectivity in the condition after medication withdrawal. A possible explanation for the increase in functional connectivity after withdrawal of AEDs is given by the inhibiting effect of pharmacological drugs on signal transport in the brain ( Rogawski, 2002 ). The AEDs reduce the synchronous firing of neuronal ensembles and therefore inhibit the propagation of seizures.…”

Section: Discussionmentioning

confidence: 99%

“…Our study was not designed to investigate differences in functional connectivity as a result of differences between sorts of drugs. Moreover, the investigation of the general effect of AEDs seems valid, because most AEDs reduce the synchronization in neuronal ensembles ( Rogawski, 2002 ). Secondly, the patient group was heterogeneous with respect to age and gender.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Network analysis of EEG related functional MRI changes due to medication withdrawal in focal epilepsy

Hermans

Ossenblok

Houdt

et al. 2015

NeuroImage: Clinical

View full text Add to dashboard Cite

Anti-epileptic drugs (AEDs) have a global effect on the neurophysiology of the brain which is most likely reflected in functional brain activity recorded with EEG and fMRI. These effects may cause substantial inter-subject variability in studies where EEG correlated functional MRI (EEG–fMRI) is used to determine the epileptogenic zone in patients who are candidate for epilepsy surgery. In the present study the effects on resting state fMRI are quantified in conditions with AED administration and after withdrawal of AEDs.EEG–fMRI data were obtained from 10 patients in the condition that the patient was on the steady-state maintenance doses of AEDs as prescribed (condition A) and after withdrawal of AEDs (condition B), at the end of a clinically standard pre-surgical long term video-EEG monitoring session. Resting state networks (RSN) were extracted from fMRI. The epileptic component (ICE) was identified by selecting the RSN component with the largest overlap with the EEG–fMRI correlation pattern. Changes in RSN functional connectivity between conditions A and B were quantified.EEG–fMRI correlation analysis was successful in 30% and 100% of the cases in conditions A and B, respectively. Spatial patterns of ICEs are comparable in conditions A and B, except for one patient for whom it was not possible to identify the ICE in condition A. However, the resting state functional connectivity is significantly increased in the condition after withdrawal of AEDs (condition B), which makes resting state fMRI potentially a new tool to study AED effects. The difference in sensitivity of EEG–fMRI in conditions A and B, which is not related to the number of epileptic EEG events occurring during scanning, could be related to the increased functional connectivity in condition B.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Network analysis of EEG related functional MRI changes due to medication withdrawal in focal epilepsy

Hermans

Ossenblok

Houdt

et al. 2015

NeuroImage: Clinical

View full text Add to dashboard Cite

show abstract

“…There is extensive evidence from RCTs that divalproex sodium (valproate) and TPM are effective in preventing migraine attacks and both drugs are approved by the US FDA for this indication ( Rogawski, 2008 ; Linde et al, 2013c , d ).…”

Section: Review Of Literature In Migrainementioning

confidence: 99%

Current Status of the New Antiepileptic Drugs in Chronic Pain

Sidhu

Sadhotra

2016

Front. Pharmacol.

View full text Add to dashboard Cite

Antiepileptic drugs (AEDs) are extensively used worldwide to treat a wide range of disorders other than epilepsy, such as neuropathic pain, migraine, and bipolar disorder. Due to this situation more than 20 new third-generation AEDs have been introduced in the market recently. The future design of new AEDs must also have potential to help in the non-epileptic disorders. The wide acceptance of second generation AEDs for the management of various non-epileptic disorders has caused the emergence of generics in the market. The wide use of approved AEDs outside epilepsy is based on both economic and scientific reasons. Bipolar disorders, migraine prophylaxis, fibromyalgia, and neuropathic pain represent the most attractive indication expansion opportunities for anticonvulsant developers, providing blockbuster revenues. Strong growth in non-epilepsy conditions will see Pfizer’s Lyrica become the market leading brand by 2018. In this review, we mainly focus on the current status of new AEDs in the treatment of chronic pain and migraine prophylaxis. AEDs have a strong analgesic potential and this is demonstrated by the wide use of carbamazepine in trigeminal neuralgia and sodium valproate in migraine prophylaxis. At present, data on the new AEDs for non-epileptic conditions are inconclusive. Not all AEDs are effective in the management of neuropathic pain and migraine. Only those AEDs whose mechanisms of action are match with pathophysiology of the disease, have potential to show efficacy in non-epileptic disorder. For this better understanding of the pathophysiology of the disease and mechanisms of action of new AEDs are essential requirement before initiating pre-clinical and clinical trials. Many new AEDs show good results in the animal model and open-label studies but fail to provide strong evidence at randomized, placebo-controlled trials. The final decision regarding the clinical efficacy of the particular AEDs in a specific non-epileptic disorder should be withdrawal from randomized placebo trials rather than open-label studies; otherwise this may lead to off-label uses of drug. The purpose of the present review is to relate the various mechanisms of action of new AEDs to pathophysiological mechanisms and clinical efficacy in neuropathic pain and migraine.

show abstract

“…There is extensive evidence from randomized controlled clinical trials that the (AEDs) divalproex sodium (valproate) and topiramate are effective in preventing migraine attacks (Rogawski, 2008). The gabapentinoids gabapentin and pregabalin may also be effective in migraine therapy (D' Amico, 2010, Calandre et al, 2010.…”

Section: Discussionmentioning

confidence: 99%