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Pediatric Neurology Sep 2006Oxcarbazepine is indicated for use as monotherapy or adjunctive therapy in the treatment of partial seizures in adults and children >or=4 years of age. The purpose of...
Oxcarbazepine is indicated for use as monotherapy or adjunctive therapy in the treatment of partial seizures in adults and children >or=4 years of age. The purpose of this retrospective chart review was to assess efficacy and tolerability of oxcarbazepine in children
oxcarbazepine between 2001 to 2004 was conducted. Twenty patients (male = 13, female = 7; ages 6-45 months [mean age 22.8 months]) who received oxcarbazepine were identified. Seizure types included partial onset (75%), symptomatic generalized (15%), and other (n = 2, 10%). Oxcarbazepine doses ranged between 14-71 mg/kg/day (mean dose: 36.5 mg/kg/day). Oxcarbazepine was prescribed as monotherapy in 15 patients and as first-line therapy in 73% patients. Overall, 70% experienced a significant reduction in seizures, and 50% became seizure-free while receiving oxcarbazepine. Transient drowsiness was reported in 20% of patients during dose escalation. No adverse events were observed in children <2 years old. The findings from this small series suggest that oxcarbazepine as monotherapy and adjunctive therapy may be effective and well tolerated in pediatric patients Topics: Age Factors; Anticonvulsants; Carbamazepine; Child, Preschool; Epilepsy; Female; Follow-Up Studies; Humans; Infant; Male; Oxcarbazepine; Retrospective Studies; Treatment Outcome
PubMed: 16939855
DOI: 10.1016/j.pediatrneurol.2006.03.003 -
Cells Apr 2023Patients diagnosed with isocitrate dehydrogenase mutant (IDH) gliomas suffer frequently from seizures. Although the clinical course is less aggressive than that of its...
Patients diagnosed with isocitrate dehydrogenase mutant (IDH) gliomas suffer frequently from seizures. Although the clinical course is less aggressive than that of its IDH wildtype counterpart, recent discoveries have shown that epileptic activity can promote tumor proliferation. However, it is not known if antiepileptic drugs confer additional value by inhibiting tumor growth. In this study, the antineoplastic properties of 20 FDA-approved antiepileptic drugs (AEDs) were tested in six patient-derived IDH glioma stem-like cells (GSCs). Cell proliferation was assessed using the CellTiterGlo-3D assay. Two of the screened drugs (oxcarbazepine and perampanel) demonstrated an antiproliferative effect. A subsequent eight-point dose-response curve proved the dose-dependent growth inhibition for both drugs, but only oxcarbazepine reached an IC value below 100 µM in 5/6 GSCs (mean 44.7 µM; range 17.4-98.0 µM), approximating the possible c for oxcarbazepine in patient serums. Furthermore, the treated GSC spheroids were 82% smaller (mean volume 1.6 nL vs. 8.7 nL; = 0.01 (live/dead fluorescence staining)), and the apoptotic events increased by more than 50% (caspase-3/7 activity; = 0.006). Taken together, this drug screen of a large series of antiepileptic drugs identified oxcarbazepine as a potent proapoptotic drug in IDH GSCs, which combines antiepileptic and antineoplastic properties to treat this seizure-prone patient population.
Topics: Humans; Anticonvulsants; Oxcarbazepine; Isocitrate Dehydrogenase; Brain Neoplasms; Glioma
PubMed: 37190109
DOI: 10.3390/cells12081200 -
Methods in Molecular Biology (Clifton,... 2024Oxcarbazepine (Trileptal) has been found effective in the treatment of tonic-clonic seizures and partial seizures with or without secondary generalization, with fewer...
Oxcarbazepine (Trileptal) has been found effective in the treatment of tonic-clonic seizures and partial seizures with or without secondary generalization, with fewer side effects than traditional therapy. Oxcarbazepine is a keto analogue of carbamazepine. It is rapidly reduced to 10-monohydroxy carbamazepine (MHD), its active metabolite. This assay measures concentrations for oxcarbazepine metabolite (MHD), internal standard (MHD 13C) solution is added to all the patient specimens resulting in precipitation of proteins. The analytes are separated using a Phenomenex Kinetex C18 column and are detected with a mass spectrophotometer utilizing multiple reaction monitoring (MRM). The analytes are qualitatively identified and quantitated from a calibration curve generated from calibrators included in the run.
Topics: Humans; Oxcarbazepine; Chromatography, Liquid; Tandem Mass Spectrometry; Carbamazepine; Seizures; Anticonvulsants; Chromatography, High Pressure Liquid; Reproducibility of Results
PubMed: 38036839
DOI: 10.1007/978-1-0716-3541-4_35 -
The Annals of Pharmacotherapy Oct 2006To report the novel finding of a significant improvement in essential tremor symptoms with oxcarbazepine in a patient with a suboptimal response to propranolol.
OBJECTIVE
To report the novel finding of a significant improvement in essential tremor symptoms with oxcarbazepine in a patient with a suboptimal response to propranolol.
CASE SUMMARY
A 40-year-old woman with a history of substance abuse complicated by essential tremor and neuropathic pain was admitted to our addictions unit with altered mental state due to escalating use of alprazolam. Alprazolam had been prescribed several months prior to admission for treatment of anxiety. The doses had risen to 5-10 mg/day during that period. Apparently, her essential tremor had responded inadequately to propranolol, but had responded well to alprazolam. She was started on a sedative/hypnotic withdrawal protocol, but did not require treatment with phenobarbital. She subsequently rated her tremor as "moderately severe." On discontinuation of the withdrawal protocol, oxcarbazepine 450 mg twice daily was initiated to treat her neuropathic pain, and the tremor improved, with a clinically significant reduction in tremor and a decreased pain score.
DISCUSSION
Essential tremor is a common neurologic disorder with uncertain pathophysiology. Practice guidelines advocate the use of propranolol or primidone as first-line agents to treat essential tremor. Unfortunately, primidone has abuse potential and propranolol has variable pharmacokinetics; these characteristics limit their effectiveness in treating tremor. Our patient experienced a significant and sustained improvement in her tremor following the initiation of oxcarbazepine. To our knowledge, as of September 2, 2006, this is the first report of the use of oxcarbazepine in essential tremor. While the exact therapeutic action remains unclear, oxcarbazepine offers significant advantages compared with current first-line agents, including its good tolerability profile, the extended half-life of its metabolite, and lack of abuse potential.
CONCLUSIONS
We report a case of essential tremor responding to oxcarbazepine. This drug offers several potential advantages over current first-line agents. Further research is warranted to test the robustness of this preliminary finding.
Topics: Adult; Carbamazepine; Essential Tremor; Female; Humans; Oxcarbazepine; Propranolol
PubMed: 16968828
DOI: 10.1345/aph.1H131 -
Journal of Neurology, Neurosurgery, and... Apr 1989The efficacy and tolerability of oxcarbazepine, a keto derivative of carbamazepine, has been assessed in six patients (two males, four females; mean age 61 years, range...
The efficacy and tolerability of oxcarbazepine, a keto derivative of carbamazepine, has been assessed in six patients (two males, four females; mean age 61 years, range 42-77), with trigeminal neuralgia refractory to carbamazepine therapy, over a period of 6 months. An excellent therapeutic response to oxcarbazepine was seen in all patients with pain control correlating well with serum drug concentrations of oxcarbazepine and its primary active metabolite 10-OH-carbazepine. Onset of the effect was observed within 24 hours in all cases. An overall serum therapeutic concentration range, in the six patients, of 50-110 mumol/l of 10-OH-carbazepine corresponding to a daily effective dose range of 1200-2400 mg (14.6-35.6 mg/kg body weight) oxcarbazepine, was observed. There was a significant correlation between oxcarbazepine dose and serum oxcarbazepine (r = 0.695, p less than 0.05) and 10-OH-carbazepine (r = 0.957, p less than 0.001) concentrations. Oxcarbazepine was well tolerated and no significant side effects were identified, though a mild hyponatraemia was observed during high doses (greater than 28 and greater than 35 mg/kg/day) in two patients. It is concluded that oxcarbazepine has potent antineuralgic properties in the absence of significant side effects and therefore may be useful in the management of intractable trigeminal neuralgia.
Topics: Adult; Aged; Biotransformation; Carbamazepine; Female; Humans; Male; Middle Aged; Oxcarbazepine; Pain Measurement; Trigeminal Neuralgia
PubMed: 2738589
DOI: 10.1136/jnnp.52.4.472 -
Journal of Clinical Psychopharmacology Feb 2010
Topics: Adult; Anticonvulsants; Bipolar Disorder; Carbamazepine; Female; Humans; Neutropenia; Oxcarbazepine
PubMed: 20075666
DOI: 10.1097/JCP.0b013e3181c97c29 -
Pharmaceutical Research Jul 2023Oxcarbazepine (OXC) is a frequently prescribed antiepileptic drug for managing focal and generalized seizures. Its therapeutic benefits are limited by its dose-dependent...
BACKGROUND
Oxcarbazepine (OXC) is a frequently prescribed antiepileptic drug for managing focal and generalized seizures. Its therapeutic benefits are limited by its dose-dependent side effects. Nose-to-brain delivery is a novel route for improving the efficacy of antiepileptics. Drug encapsulation in mucoadhesive nanoparticles offers even more advantages for the nasal route.
OBJECTIVE
The study aimed to develop oxcarbazepine-loaded chitosan nanoparticles (OXC-NP) added to a mucoadhesive thermo-reversible gel for intranasal delivery and enhancement of antiepileptic activity.
METHODS
The formulation was optimized based on entrapment efficiency, polydispersity index, particle size, zeta potential, and in vitro release analysis. The therapeutic efficacy of OXC-NP was assessed in an epileptic rat model and compared to intranasal OXC and oral OXC.
RESULTS
The optimized OXC-NPs with chitosan exhibited particle size, zeta potential, and entrapment efficiency of 189 nm, + 31.4 mV ± 2.5 and 97.6% ± 0.14, respectively. The release of OXC was prolonged, reaching 47.1% after 6 h and 55% after 24 h. Enhanced antiepileptic activity of OXC-NP was manifested as decreased seizure score and prolonged survival. Halting of hippocampal TNF-α and IL-6 together with upregulated IL-10 could explain its anti-inflammatory mechanisms.
CONCLUSIONS
Intranasal OXC-NP-loaded in situ gel represents a promising formulation for enhanced antiepileptic potential achieved at low drug concentrations.
Topics: Rats; Animals; Anticonvulsants; Oxcarbazepine; Chitosan; Brain; Administration, Intranasal; Nanoparticles; Particle Size; Drug Carriers
PubMed: 37353628
DOI: 10.1007/s11095-023-03552-7 -
Therapeutic Drug Monitoring Apr 2020Carbamazepine and oxcarbazepine are potent modulators of metabolic enzymes. Hence, potential drug-drug interactions (DDIs) may occur between these 2 drugs and...
BACKGROUND
Carbamazepine and oxcarbazepine are potent modulators of metabolic enzymes. Hence, potential drug-drug interactions (DDIs) may occur between these 2 drugs and antiretrovirals. Here, we aimed to assess the relevance of these drug-drug interactions in real-life clinical settings.
METHODS
Patients treated concomitantly with carbamazepine or oxcarbazepine and antiretrovirals for at least 3 months were considered. Data on therapeutic drug monitoring (TDM) of both antiepileptic and antiretrovirals as trough concentrations were collected. HIV-infected patients not concomitantly treated with antiepileptic drugs and who underwent TDM for antiretrovirals in the previous 2 years were considered as controls.
RESULTS
Eleven HIV-positive patients prescribed carbamazepine or oxcarbazepine were identified. All the TDM evaluations for carbamazepine and oxcarbazepine that resulted were within the therapeutic ranges. TDM results of darunavir measured in these patients were comparable with values usually measured in the control group. Conversely, the trough concentrations for atazanavir and dolutegravir demonstrated significantly lower values when compared with values usually measured in HIV-infected patients not treated with antiepileptic drugs (190 ± 91 versus 546 ± 380 ng/mL; -65%, P < 0.001; 191 ± 78 versus 1096 ± 510 ng/mL; -83%, P < 0.001, respectively).
CONCLUSIONS
Co-administration of carbamazepine or oxcarbazepine with atazanavir or dolutegravir should be avoided owing to the potential risk of virological failure; in case of these 2 drugs, the adoption of TDM is strongly advisable, eventually combining with increased antiretroviral doses.
Topics: Adult; Anti-Retroviral Agents; Anticonvulsants; Atazanavir Sulfate; Carbamazepine; Darunavir; Drug Interactions; Drug Monitoring; Female; HIV Infections; Heterocyclic Compounds, 3-Ring; Humans; Male; Middle Aged; Oxazines; Oxcarbazepine; Piperazines; Pyridones
PubMed: 31743292
DOI: 10.1097/FTD.0000000000000715 -
Annals of Allergy, Asthma & Immunology... Oct 2019
Topics: Adolescent; Anticonvulsants; Desensitization, Immunologic; Drug Hypersensitivity; Exanthema; Female; Humans; Oxcarbazepine; Stevens-Johnson Syndrome
PubMed: 31201862
DOI: 10.1016/j.anai.2019.06.001 -
CNS Neuroscience & Therapeutics Jul 2022This multicenter, open-label, randomized study (Registration No. ChiCTR-OCH-14004528) aimed to compare the efficacy and effects of oxcarbazepine (OXC) with levetiracetam... (Randomized Controlled Trial)
Randomized Controlled Trial
Efficacy comparison of oxcarbazepine and levetiracetam monotherapy among patients with newly diagnosed focal epilepsy in China: A multicenter, open-label, randomized study.
AIMS
This multicenter, open-label, randomized study (Registration No. ChiCTR-OCH-14004528) aimed to compare the efficacy and effects of oxcarbazepine (OXC) with levetiracetam (LEV) as monotherapies on patient quality of life and mental health for patients with newly diagnosed focal epilepsy from China.
METHODS
Patients with newly diagnosed focal epilepsy who had experienced 2 or more unprovoked seizures at greater than a 24-h interval during the previous year were recruited. Participants were randomly assigned to the OXC group or LEV group. Efficacy, safety, quality of life, and mental health were evaluated over 12-week and 24-week periods.
RESULTS
In total, we recruited 271 newly diagnosed patients from 23 centers. Forty-four patients were excluded before treatment for reasons. The rate of seizure freedom of OXC was significantly superior to that of LEV at 12 weeks and 24 weeks (p < 0.05). The quality of life (except for the seizure worry subsection) and anxiety scale scores also showed significant differences from before to after treatment in the OXC and LEV groups.
CONCLUSIONS
OXC monotherapy may be more effective than LEV monotherapy in patients with newly diagnosed focal epilepsy. Both OXC and LEV could improve the quality of life and anxiety state in adult patients with focal epilepsy.
Topics: Adult; Anticonvulsants; Epilepsies, Partial; Humans; Levetiracetam; Oxcarbazepine; Quality of Life; Seizures; Treatment Outcome
PubMed: 35429132
DOI: 10.1111/cns.13840