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Objective To evaluate the efficacy and safety of levetiracetam (LTA) for adult seizure (AS). Methods A randomized, double-blinded, double-dummy, positive drug controlled trial was conducted. One hundred and twenty eligible AS patients were randomly divided into two groups: intervention group and control group, with 60 in each group. Patients in the intervention group received LTA tablet plus valproate sodium mimetic tablet, and patients in the control group received valproate sodium tablet and LTA mimetic tablet. The treatment course was 26 weeks in both groups, and the patients was followed up for 3 months after the treatment. The outcomes included total efficacy rate, weekly epilepsy seizure frequency, seizure duration, quality of life (measured by QOLIE-31 Scale) and adverse events related to drugs after 1-3 days of treatment and at 3 months of follow-up. Results The weekly epilepsy seizure frequency, seizure duration and QOLIE-31 score were not significantly different between the two groups before treatment. The total efficacy rates after treatment and at 3 months of follow-up in the intervention group were 95. 0% (57/60) and 91 7% (55/60), respectively, and were significantly higher than those in the control group of 71 7% (43/60) and 63. 3% (38/60) (P<0 01). The weekly epilepsy seizure frequency, seizure duration and QOLIE-31 score after treatment and at 3 months of follow-up were significantly different as compared with before treatment in both groups (P<3. 01); and there were significantly different between the two groups (P<3 01). The adverse events after treatment were similar between both groups. Conclusion The efficacy of LAT is superior to the valproate sodium tablet for AS, with the less toxicity, and it can be clinical drug of choice for AS.
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Objective To evaluate the efficacy and safety of levetiracetam (LTA) for adult seizure (AS).Methods A randomized,double-blinded,double-dummy,positive drug controlled trial was conducted.One hundred and twenty eligible AS patients were randomly divided into two groups:intervention group and control group,with 60 in each group.Patients in the intervention group received LTA tablet plus valproate sodium mimetic tablet,and patients in the control group received valproate sodium tablet and LTA mimetic tablet.The treatment course was 26 weeks in both groups,and the patients was followed up for 3 months after the treatment.The outcomes included total efficacy rate,weekly epilepsy seizure frequency,seizure duration,quality of life (measured by QOLIE-31 Scale) and adverse events related to drugs after 1-3 days of treatment and at 3 months of follow-up.Results The weekly epilepsy seizure frequency,seizure duration and QOLIE-31 score were not significantly different between the two groups before treatment.The total efficacy rates after treatment and at 3 months of follow-up in the intervention group were 95.0％ (57/60) and 91.7％ (55/60),respectively,and were significantly higher than those in the control group of 71.7％ (43/60) and 63.3％ (38/60) (P＜0.01).The weekly epilepsy seizure frequency,seizure duration and QOLIE-31 score after treatment and at 3 months of follow-up were significantly different as compared with before treatment in both groups (P＜0.01);and there were significantly different between the two groups (P＜0.01).The adverse events after treatment were similar between both groups.Conclusion The efficacy of LAT is superior to the valproate sodium tablet for AS,with the less toxicity,and it can be clinical drug of choice for AS.
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Objective:To investigate the effects of valproate sodium on P-CREB1 after hippocampal neuronal epileptiform discharge in rat.Methods:The neonate wistar rats were decapitated quickly to obtain the hippocampal neuron,Which were cultured in vitro,After the epileptiform discharge model of neuron was established,neurons were divided into control group,model group,low valproate dose group(50mg/L) and high dose group(100mg/L).Expression positions of P-CREB1 after epileptiform discharge were examined by immunofluorescence technique,and Western blot was used to examine the expression intensity of P-CREB1 in different group.Results:Through immunofluorescence,P-CREB1 was observed in the nucleus of each group,and the most intensive expression was found in model group.Through western blot,the expression tendency was found to be the same as the former Results,Moreover,after added valproate sodium,the expression of P-CREB1 decreased,and there was statistical significance of the difference between low valproate dose and high dose(P
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Objective To study the influence of valproate sodium(VPA)on neuroprotective effects of topiramate(TPM).Methods For-ty-eight 3-4 week-old male Wistar rats were randomly divided into 4 groups of 12 rats each.Group A was negative control rats,and groups B-D were rat model of epilepsy,induced by pentylenetetrazol(PTZ).The rats in 2 experimental groups were adminstered intragastrically with TPM 40 mg/kg and TPM 40 mg/kg+ VPA 200 mg/kg;2 control groups(groups A and B)with the equal amount of distilled water administration.After 2-month administration,changes of the behavior,levels of serum neuron-specific enolase(NSE)and the pathological in hippocampus were examined.Results The level of NSE in the group of TPM were significantly lower than that in masculine group,but no difference between masculine group and the TPM plus VPA.The pathological change in hippocampus were abatement in the group of TPM.Conclusion TPM plus high dosage of VPA will impaire the neuroprotective effects of TPM.
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Objective To explore the blood drug concentration monitoring of sustained-release valproate(DK)in children with epilepsy,focusing on the selection of sampling time and evaluation of the results.Methods Two hundred and seventy-one children taking DK and 155 children taking sodium valproate syrup(VPA Syr)were involved and their serum were taken when achieved steady state to determine the valproic acid level using fluorescence polarization immunoassay.They were divided into 4 groups,which were DK taken once daily group(DK qd group,126 children),DK taken once daily at night and sampled on morning group(DK qn group,26 children),DK taken every 12 h group(DK q12 h group,119 children),VPA Syr q12 h group(155 children).Determine the proportion of the blood drug concentration of each group below,ithin and above the therapeutic range for valproate(50-100 mg/L)were determined.The data were analyzed by t test.Results The Cmin of DK qd group were(73.09?19.91)mg/L,significantly lower from the serum concentration of DK qn and sampled on morning group [(94.94?25.44)mg/L](P0.05).Conclusions DK qn should sampled at night before the night dose.The Cmin of DK q12 h was higher according to the therapeutic range,it's favorable range still needs clinical practice.
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AIM: To investigate the role and mechanism of a novel antiepileptic drug topiramate on amygdala kindling in rats. METHODS: The effects and mechanism of topiramate on kindling were examined by the establishment of amygdala kindling model and combination with other drugs. The influence of topiramate on seizures induced by semicarbazide hydrochloride (SCZ) was also observed. RESULTS: Topiramate (50-200 mg·kg-l,ig) dose-dependently inhibited the seizure severity in amygdala kindling (P<0.05). The combination of topiramate with valproate sodium or nicardipine, all in ineffective doses on kindling, decreased ADD(P<0.05). Topiramate 200 mg·kg-l, ig decreased the rate of seizure and death induced by SCZ in mice(P<0.01). CONCLUSION: Topiramate can significantly inhibit amygdala kindling in rats, and has synergism with valproate sodium and nicardipine, with the possible mechanism of GABA-ergic inhibition as well as Ca2+-channel blockade.
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OBJECTIVE: To approach efficacy of Dianning tablet in the treatment of refractoriness epilepsy.METHODS: 180 patients with refractoriness epilepsy were randomized into treatment group,control group Ⅰand control group Ⅱ(n=60).Treatment group were given Dianning tablet produced by our hospital.Control group Ⅰwere treated with carbamazepine tablet and clonazepam tablet while control group Ⅱ were treated with valproate sodium tablet and clonazepam tablet.The efficacies of three groups were compared after 6 months.RESULTS: Treatment group was better than control groups in total effective rate,seizure frequency and improvement of EEG (P
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Objective To investigate the correlation between the alleles polymorphism of CYP2A6 and CYP2B6 and blood concentration of Valproate sodium(VPA).Methods The 165 epilepsy patients received simplex VPA and without dysfunction of liver and kidney were chose in this study.The alleles polymorphism of CYP2A6 in 95 cases and CYP2B6 in 70 cases were detected by polymerase chain reaction(PCR).Fluorescence polarization immunoassay(FPIA) was used to measure the blood concentration of VPA.Results The frequence of allele CYP2A6*4 in 95 cases was 13.2%.The blood concentration of VPA in patients with allele CYP2A6*4[(4.23?0.27)mg/ml]was significantly higher than that in patients without allele CYP2A6*4[(3.35?0.38)mg/ml](P
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Objective:To study the effects of valproate sodium and topiramate on spontaneous motor activity behavior and isolation-induced aggression in mice,and thus to provide evidence for drug treatment.Methods:Male Kunming mice were isolated for 40～45days as an animal model of isolation-induced aggression.The isolated and group-housed mice were administrated with different doses of valproate sodium (0mg/kg、50mg/kg、100mg/kg、200mg/kg) and topiramate(0mg/kg、25mg/kg、50mg/kg、100mg/kg).The aggressiveness of isolated mice was measured 30min after the administration of valproate sodium or 120min after the administration of topiramate.Results:Valproate sodium and topiramate could dose-dependently prolong the latencies to attacking.They could also decrease spontaneous motor activity.Conclusion:Both valproate sodium and topiramate are inhibitors of aggression behavior in isolated mice.Topiramate and valproate sodium have synergism.
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AIM To investigate the role and mechanism of a novel antiepileptic drug topiramate on amygdala kindling in rats. METHODS The effects and mechanism of topiramate on kindling were examined by the establishment of amygdala kindling model and combination with other drugs. The influence of topiramate on seizures induced by semicarbazide hydrochloride(SCZ) was also observed. RESULTS Topiramate (50～200 mg?kg -1 ,ig) dose-dependently inhibited the seizure severity in amygdala kindling ( P