Commentary on Leppik
نویسنده
چکیده
Dr. Leppik raised some important issues regarding the mechanism of action of zonisamide. There is a great deal of interest in the impact of zonisamide on the T-type calcium channel. However, the relevance of that mechanism to the clinical experience is not known. The drug’s impact on the sodium channel is one that is not unique to this antiepilepsy drug (AED). There is some unpublished scientific evidence about the impact of zonisamide on glutamate, a story that likely will continue to develop. Dr. Leppik cited the work of Dr. Miura and other investigators in Japan who have identified a link between the neuroprotective impact of zonisamide and some of the brain’s methods of handling glutamate. There are six or seven different strategies that the brain uses to keep glutamate under control, and zonisamide may have an impact on one or two of those mechanisms. The Japanese investigators, and perhaps investigators around the world, will be looking more closely at this issue of neuroprotection. Dr. Leppik provided an introduction to this concept and we hope to see more information in the future. As far as the pharmacokinetics of this drug, the half-life of zonisamide when combined with other drugs deserves attention. With zonisamide monotherapy or when zonisamide is given to a naive patient, the drug’s half-life approaches 70 h. While the effects of other AEDs were discussed, experience with non-AED medications remains a question.
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عنوان ژورنال:
- Seizure
دوره 13 شماره
صفحات -
تاریخ انتشار 2004