Chronopharmacology of Anti-Convulsive Therapy

被引：0
作者：
Sriram Ramgopal
Sigride Thome-Souza
Tobias Loddenkemper
机构：
[1] Harvard Medical School,Division of Epilepsy and Clinical Neurophysiology
[2] Children’s Hospital Boston,Department of Neurology
[3] University of Sao Paulo,Psychiatry Department of Clinics Hospital of Faculty of Medicine
来源：
Current Neurology and Neuroscience Reports | 2013年 / 13卷
关键词：
Epilepsy; Chronotherapy; Chronopharmacology; Chronopharmacokinetics; Differential dosing; Seizures; Seizure patterns; Diurnal patterns; Closed loops; Melatonin; Light therapy; Dim light melatonin onset; DLMO; Circadian rhythms; Circadian pattern; Suprachiasmatic nucleus; Seizure tracking; Seizure diary; Chronopharmacodynamics; Pharmacokinetics; Pharmacodynamics;
D O I：
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中图分类号：
学科分类号：
摘要：
Approximately one-third of patients with epilepsy continue to have seizures despite antiepileptic therapy. Many seizures occur in diurnal, sleep/wake, circadian, or even monthly patterns. The relationship between biomarkers and state changes is still being investigated, but early results suggest that some of these patterns may be related to endogenous circadian patterns whereas others may be related to wakefulness and sleep or both. Chronotherapy, the application of treatment at times of greatest seizure susceptibility, is a technique that may optimize seizure control in selected patients. It may be used in the form of differential dosing, as preparations designed to deliver sustained or pulsatile drug delivery or in the form of ‘zeitgebers’ that shift endogenous rhythms. Early trials in epilepsy suggest that chronopharmacology may provide improved seizure control compared with conventional treatment in some patients. The present article reviews chronopharmacology in the treatment of epilepsy as well as future treatment avenues.
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