Fighting Epilepsy with Nanomedicines—Is This the Right Weapon?

Abstract

Epilepsy is a chronic and complex condition and is one of the most common neurological diseases, affecting about 50 million people worldwide. Pharmacological therapy has been, and is likely to remain, the main treatment approach for this disease. Although a large number of new antiseizure drugs (ASDs) has been introduced into the market in the last few years, many patients suffer from uncontrolled seizures, demanding the development of more effective therapies. Nanomedicines have emerged as a promising approach to deliver drugs to the brain, potentiating their therapeutic index. Moreover, nanomedicine has applied the knowledge of nanoscience, not only in disease treatment but also in prevention and diagnosis. In the current review, the general features and therapeutic management of epilepsy will be addressed, as well as the main barriers to overcome to obtain better antiseizure therapies. Furthermore, the role of nanomedicines as a valuable tool to selectively deliver drugs will be discussed, considering the ability of nanocarriers to deal with the less favourable physical-chemical properties of some ASDs, enhance their brain penetration, reduce the adverse effects, and circumvent the concerning drug resistance.

Nanotherapeutics for Alleviating Anesthesia‐Associated Complications

“…[ 159 ] For drug‐resistant epilepsy, alternative treatments may include surgical interventions and specialized dietary regimens, such as the ketogenic diet. [ 253 ] Status epilepticus (SE), characterized by continuous and repetitive seizures, is a medical emergency that may lead to severe neurological complications and a short‐term mortality rate ranging from 15% to 20%.…”

“…Epilepsy is a prevalent and chronic neurological disorder characterized by hyperactive neurons and brain circuits with synchronous electrical discharges. [ 159 , 253 ] While the occurrence of seizures in the perioperative period is relatively low, it remains imperative to comprehend the antiepileptic or pro‐epileptic properties of anesthetics. [ 159 ] Most anesthetics exert suppressive effects on neurological processes and possess varying degrees of anticonvulsant properties.…”

“…[ 253 ] Clinical antiepileptic drugs such as PHT, carbamazepine (CBZ), and lamotrigine (LTG) have been encapsulated within various nanoplatforms to gain several benefits, including improved bioavailability, enhanced BBB permeation, avoidance of first‐pass liver metabolism, reduced drug resistance, and mitigation of side effects. [ 253 , 255 , 256 , 257 ] For instance, conventional administration of CBZ is hampered by several factors, including autoinduction of liver enzymes leading to rapid metabolism, a short half‐life time, a narrow therapeutic window, susceptibility to side effects, and efflux transporters limiting brain access. To address these challenges, intranasal delivery of CBZ‐loaded carboxymethyl chitosan (CMC) NPs (denoted ‘CBZ‐NPs’) has been proposed as a solution.…”

Crosslinked Chitosan Nanoparticles with Muco-Adhesive Potential for Intranasal Delivery Applications

“…The maximization of the effective drug dose in brain targeting is fundamental, and the encapsulation of the drug in mucoadhesive vectors, such as polymeric nanoparticles ( NPs ), is a valid strategy for poorly mucoadhesive active principles [ 12 ] and non-invasive brain delivery. The recent literature reports some interesting polymer, lipid, and inorganic NP-based applications for nose-to-brain delivery [ 13 ].…”