New routes for delivery of anti-epileptic medications.
Use of novel drug delivery methods might enhance efficacy and reduce toxicity, in comparison with currently existing oral anti-epileptic drugs (AEDs). Novel methods aim to deliver optimal drug concentration more specifically to the seizure focus or foci. In this review, we first consider unconventional routes of drug delivery to the peripheral system, then potential new methods of targeted CNS drug delivery. Intrathecal or intraventricular AEDs might circumvent systemic toxicity. Drug-eluting wafers could be surgically positioned over an epileptogenic region of brain. Drug can be delivered to a seizure focus by an implanted catheter and subcutaneous pump. Inactive prodrugs, given systemically, can be made active only at the seizure focus, by interaction with locally-released substances. Liposomes and polysomes are engineered slow-release storage vehicles for drugs. Targeting components can hold liposomes near a region of interest, provided that they can penetrate the blood brain barrier. Lastly, we discuss future prospects for the use of transplanted cells and genes as potential vehicles for local delivery of renewable anti-epileptic regimen.
Fisher
Robert S
RS
Stanford Comprehensive Epilepsy Center, Stanford University Medical Center, 300 Pasteur Drive, Stanford, California 94305-5235, USA. rfisher@stanford.edu
Chen
David K
DK
D000927:Anticonvulsants / Q000008:administration & dosage*; D002404:Catheterization; D016503:Drug Delivery Systems; D004827:Epilepsy / Q000628:therapy*; D015316:Genetic Therapy; D006801:Humans; D008081:Liposomes; D019737:Transplants
D000927:Anticonvulsants; D008081:Liposomes