Old Drugs Find New Paths to the Brain
Old Drugs Find New Paths to the Brain
At the most recent American Epilepsy Society Annual Meeting, Michael Sperling, MD, and colleagues presented an abstract detailing the effectiveness, pharmacokinetics, and safety of intranasal diazepam in stopping seizures.
Intravenous diazepam is one of the most commonly used treatments for status epilepticus. Rectal diazepam (Diastat®) has also been approved for the treatment of seizure clusters. However, both of these conventional routes have limitations in terms of drug delivery to people in the acute throes of an epileptic attack that may potentially be circumvented by the more easily accessible nasal route.
In a multicenter, open-label, pharmacokinetic study, 31 adults with epilepsy had their antiepileptic drugs withdrawn in the epilepsy monitoring unit. Subsequent seizures were treated with intranasal diazepam spray (0.2 mg/kg) instead of a conventional benzodiazepine.
After receiving intranasal diazepam, 20 patients (65%) were seizure-free, compared with 11 (35%) who had post-dose seizures (average time of 4.8 hours to first post-dose seizure) during the 12-hour observation period. Three (10%) required rescue lorazepam. The most common adverse events were dysgeusia (26%), nasal discomfort (23%), lacrimation (16%), rhinorrhea (16%), oropharyngeal pain (13%), paranasal sinus hypersecretion (13%), nasal congestion (10%), parosmia (10%), and throat irritation (7%).
Intranasal Diazepam
At the most recent American Epilepsy Society Annual Meeting, Michael Sperling, MD, and colleagues presented an abstract detailing the effectiveness, pharmacokinetics, and safety of intranasal diazepam in stopping seizures.
Intravenous diazepam is one of the most commonly used treatments for status epilepticus. Rectal diazepam (Diastat®) has also been approved for the treatment of seizure clusters. However, both of these conventional routes have limitations in terms of drug delivery to people in the acute throes of an epileptic attack that may potentially be circumvented by the more easily accessible nasal route.
Exciting Research
In a multicenter, open-label, pharmacokinetic study, 31 adults with epilepsy had their antiepileptic drugs withdrawn in the epilepsy monitoring unit. Subsequent seizures were treated with intranasal diazepam spray (0.2 mg/kg) instead of a conventional benzodiazepine.
After receiving intranasal diazepam, 20 patients (65%) were seizure-free, compared with 11 (35%) who had post-dose seizures (average time of 4.8 hours to first post-dose seizure) during the 12-hour observation period. Three (10%) required rescue lorazepam. The most common adverse events were dysgeusia (26%), nasal discomfort (23%), lacrimation (16%), rhinorrhea (16%), oropharyngeal pain (13%), paranasal sinus hypersecretion (13%), nasal congestion (10%), parosmia (10%), and throat irritation (7%).
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