A new study has explored one aspect of epilepsy medicines that is often overlooked: whether they have inflammatory or anti-inflammatory properties. Knowing which effect a drug may have in the brain might – and should – influence whether it is prescribed to a particular patient
The study was conducted in Germany by scientists at the Ruhr-Universitat Bochum (RUB). It was designed to test how inflammatory four particular epilepsy medicines were. The four medicines tested were valproic acid, gabapentin, phenytoin and carbamazepine.
Scientists at RUB realised that the inflammatory properties of these epilepsy medicines had not been tested – but might have a significant impact on treatment.
Inflammation is a response of your body’s immune system, often as a result of an infection. The main symptoms are redness, swelling and irritation. It is known that some forms of epilepsy are caused by inflammation in the brain. In this case, knowing whether a drug may have inflammatory or anti-inflammatory properties might seriously impact how appropriate it is as an epilepsy treatment.
RUB scientists explored this by looking at glial cells. Glial cells are the largest group of cells in the brain. The are like support cells; they provide neurons (the cells that transmit information) with nutrients and they affect immune responses – such as inflammation.
The research team grew these glial cells in laboratory cell cultures so they could test how the epilepsy medicines affected their survival rate. The glial cells had better chances of surviving when exposed to valproic acid or gabapentin than when exposed to phenytoin or carbamazepine.
This suggests that the first two medicines would be better treatments for epilepsy where the condition is caused by inflammation in the brain. However, carbamazepine had a positive effect, too – it reduced inflammation. While valproic acid and gabapentin were better for the survival of glial cells, valproic also made inflammation worse.
This information shows how important it is to select the right treatment for each patient. For instance, if someone’s epilepsy was the result of brain inflammation, they may be better taking carbamazepine than valproic acid. Carbamazepine would reduce the inflammation while also treating seizures.
Study leader, Pedro Faustman, said: “Clinical studies should focus not only on the question [of] how far epilepsy drugs affect the severity and frequency of epileptic seizures. It is also necessary to test them with regard to the role they play in inflammatory responses in the central nervous system.”