Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical efficacy of phensuximide and methsuximide was studied in relation to plasma concentrations of these compounds and their desmethyl metabolites. Single- and chronic-dose studies of each drug were carried out in five patients with intractable seizures. Patients were evaluated before and during treatment by 6-hour simultaneous video and telemetered electroencephalographic recordings to characterize the seizure type and by daily determinations of plasma antiepileptic drug concentrations. Phensuximide had a mean half-life of 7.8 hours and accumulated to an average fasting level of only 5.7 micrograms per milliliter. Desmethylphensuximide averaged only 1.7 micrograms per milliliter with a similar half-life. Methsuximide had an even shorter half-life, averaging 1.4 hours, but its desmethyl metabolite had a mean half-life of 38 hours and therefore accumulated to levels in excess of 40 micrograms per milliliter. The addition of phensuximide to their regimens benefited none of the patients, but two had an excellent response to methsuximide. The failure of phensuximide and its desmethyl metabolite to accumulate to reasonable levels is the likely explanation for the relatively weak antiepileptic effect of phensuximide as compared with methsuximide.
 ...
PMID:Plasma concentrations of phensuximide, methsuximide, and their metabolites in relation to clinical efficacy. 11 42

Methsuximide was added to the therapeutic regimens of 25 children with intractable epilepsy. In 15 patients the drug was well tolerated and resulted in a 50% or greater reduction in seizure frequency. No serious or irreversible adverse effects were seen. Methsuximide is frequently overlooked and may be an effective adjunctive antiepileptic for children with intractable seizures.
 ...
PMID:Methsuximide for intractable childhood seizures. 195 55

The efficacy of second-line antiepileptic drugs (AEDs) was evaluated in the treatment of 66 patients with complex partial seizures who had previously failed first-line AEDs. Methsuximide, valproate, or clorazepate had eliminated seizures in 11% of the patients at the end of the study. However, these good results deteriorated on longer follow-up and were not expected to be permanent. It is recommended that suitable patients with partial epilepsy be referred for surgical evaluation after failing the first-line AEDs, and that second-line AEDs be reserved for nonsurgical candidates.
 ...
PMID:Efficacy of second line antiepileptic drugs in the treatment of patients with medically refractive complex partial seizures. 308 21

The efficacy and safety of methsuximide were evaluated for 12 weeks in 21 patients with complex partial (psychomotor) seizures refractory to conventional anticonvulsants. After addition of methsuximide to the previous anticonvulsant regimens, the number of complex partial seizures per patient decreased from a weekly average of 5.8 to 0.9 seizures. A 90 to 100% control of complex partial seizures was achieved in 15 (71%) of the patients. Dose reduction or discontinuation of one or more previous medications was possible in 42%. Seizure control was optimal at methsuximide doses of 9.5 to 11.0 mg per kilogram per day and plasma levels of 20 to 24 micrograms per milliliter. Adverse experiences, particularly somnolence and lethargy, were reported by 12 patients. Methsuximide appeared to be an effective and generally well tolerated adjunct medication in the management of complex partial seizures.
 ...
PMID:Methsuximide for refractory complex partial seizures. 689 34

Currently valproic acid is considered to be the drug of first choice for juvenile myoclonic epilepsy (JME) resulting in a 70-90% control rate for all seizure types associated with JME. In those situations where valproic acid fails to control seizure activity, results in unacceptable side-effects, or is declined due to potential side-effects, an alternative effective monotherapy would be desirable. Five adolescent female patients were placed on methsuximide for JME. All five patients have been seizure free with the use of methsuximide and four out of five are now on methsuximide monotherapy with good success. C.L. has now had complete seizure control on methsuximide monotherapy, a total of 1200 mg a day, for 7 years with the exception of one seizure event occurring on an attempted discontinuation of methsuximide after being 5 years seizure free. Methsuximide monotherapy as demonstrated in these five patients is an effective treatment for JME.
Seizure 1996 Mar
PMID:Methsuximide therapy of juvenile myoclonic epilepsy. 877 52