TCM Substances in Neuropsychopharmacotherapy: Basic Aspects with a Focus on Depression

Naoi, Makoto; Maruyama, Wakako; Riederer, Peter

doi:10.1007/978-3-030-62059-2_394

Cited by 1 publication

(5 citation statements)

References 120 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 15 Therefore, the steady state of recommended daily maintenance doses, spanning 100 mg to 400 mg, is usually attained after several weeks to months. 3 , 5 , 6 , 7 , 39 , 40 , 41 Still, early beneficial effects on seizure frequencies at rather low daily doses were reported earlier both by post hoc analyses of the pivotal trials and from observational real‐world studies. 24 , 28 , 42 , 43 We still did not analyze efficacy data after 3 months in detail.…”

Section: Discussionmentioning

confidence: 79%

“…Its precise mode of action is yet to be fully elucidated. 2 , 3 , 4 , 5 , 6 , 7 So far, two potentially complimentary mechanisms have been delineated. The first involves the reduction of repetitive neuronal discharges by CNB via the inhibition of voltage‐dependent sodium channels.…”

Section: Introductionmentioning

confidence: 99%

“…The first involves the reduction of repetitive neuronal discharges by CNB via the inhibition of voltage‐dependent sodium channels. 6 , 7 , 8 , 9 , 10 In particular, CNB augments the rapid and complete inactivation of sodium channels, and, akin to lacosamide (LCM), suppresses the non‐activating component of the sodium current (I NaP ) in hippocampal rat neurons in a concentration‐dependent manner. 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 The second potential mechanism of action involves γ‐amino butyric acid (GABA).…”

Section: Introductionmentioning

confidence: 99%

“… 6 , 7 , 8 , 9 , 10 In particular, CNB augments the rapid and complete inactivation of sodium channels, and, akin to lacosamide (LCM), suppresses the non‐activating component of the sodium current (I NaP ) in hippocampal rat neurons in a concentration‐dependent manner. 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 The second potential mechanism of action involves γ‐amino butyric acid (GABA). 6 , 7 , 10 , 12 , 14 CNB has previously been shown to potentiate GABA‐induced currents in acutely isolated CA3 pyramidal cells in a concentration‐dependent manner.…”

Section: Introductionmentioning

confidence: 99%

“… 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 The second potential mechanism of action involves γ‐amino butyric acid (GABA). 6 , 7 , 10 , 12 , 14 CNB has previously been shown to potentiate GABA‐induced currents in acutely isolated CA3 pyramidal cells in a concentration‐dependent manner. Additionally, CNB acted as a positive allosteric modulator of high‐affinity GABA A receptors, activated by GABA at a site independent of the benzodiazepine binding site, thereby enhancing tonic inhibition in hippocampal neurons.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The cenobamate KORK study—A prospective monocenter observational study investigating cenobamate as an adjunctive therapy in refractory epilepsy, with comparisons to historical cohorts treated with add‐on lacosamide, perampanel, and brivaracetam

Steinhoff,

Georgiou,

Intravooth

2024

Epilepsia Open

View full text Add to dashboard Cite

ObjectiveIn Europe, cenobamate has been approved for use as an adjunctive therapy in adult patients with epilepsy (PWE) with focal‐onset seizures (FOS) who have not responded satisfactorily to treatment with at least two antiseizure medications (ASMs). Pivotal trials and real‐world observational studies have demonstrated a high efficacy of cenobamate, even in very difficult‐to‐treat epilepsies. Our aim was to investigate the efficacy of add‐on cenobamate in adult PWE who were prospectively monitored. We compared these results with those previously obtained for add‐on lacosamide, perampanel, and brivaracetam therapy.MethodsPatients were enrolled from the CENKORK study, which is a prospective, non‐interventional, open‐label, monocenter cohort study of adult PWE experiencing FOS. The titration of cenobamate was performed according to the guidelines outlined in the summary of product characteristics. The primary outcome measure was the retention rate at 6 months and 1 year. In addition, we assessed seizure‐free rates, the proportion of patients achieving at least a 50% seizure reduction, adverse events, and the reasons for treatment discontinuation. These outcome measures were compared with historical controls treated with adjunctive lacosamide, perampanel, or brivaracetam at our center.ResultsBetween June 2021 and 2022, 172 PWE with ongoing FOS were included. 22 cases were lost to follow‐up, leaving 150 cases for the 1‐year assessment. The retention rates at 6 months and 1 year were 88.7% and 80%, respectively. Seizure freedom was achieved in 14% of patients at both the 6‐month and 1‐year marks, while the ≥50% responder rates were 50% and 61%, respectively. The 6‐month retention rate was significantly higher in cenobamate than in other ASMs (p < 0.001 for each comparator). Adverse events were significantly more common with perampanel (p < 0.001).SignificanceAdd‐on cenobamate proved to be particularly efficacious compared to our experience with other recently introduced ASMs.Plain Language SummaryThis observational study was carried out in 172 adult patients with difficult‐to‐treat epilepsy who were treated with adjunctive cenobamate. After 1 year, the data of 150 patients could be analyzed. Seizure freedom, in the preceding 3 months, was achieved in 14%. The rate of PWE continuing cenobamate was 80%. In our hands, cenobamate showed promising efficacy and tolerability even when compared to other recently introduced antiseizure medications.

show abstract