Herbal medicine and epilepsy: proconvulsive effects and interactions with antiepileptic drugs.
The use of complementary and alternative medicine is on the rise, including among patients with epilepsy. Herbal medicine, one of the most popular forms of CAM, is considered to be both safe and effective by most consumers. Yet many herbs may increase the risk for seizures, through intrinsic proconvulsant properties or contamination by heavy metals, as well as via effects on the cytochrome P450 enzymes and P-glycoproteins, altering antiepileptic drug (AED) disposition. Herb-drug interactions may be difficult to predict, especially since the quality and quantity of active ingredients are often unknown. Since most patients do not inform their physicians that they are taking herbal medicines, health care professionals must initiate a dialogue in order to prevent complications with the combined regimen. At the same time, further research is required regarding the effect of herbs on seizure activity and interactions with AED treatment.
Samuels
Noah
N
The Center for Integrative Complementary Medicine, Shaare Zadek Medical Center, Jerusalem, Israel. refplus@netvision.net.il
Finkelstein
Yoram
Y
Singer
Shepherd Roee
SR
Oberbaum
Menachem
M
D018435:ATP Binding Cassette Transporter, Subfamily B / Q000187:drug effects / Q000378:metabolism; D000927:Anticonvulsants / Q000378:metabolism / Q000493:pharmacokinetics* / Q000627:therapeutic use; D003577:Cytochrome P-450 Enzyme System / Q000187:drug effects / Q000378:metabolism; D004827:Epilepsy / Q000188:drug therapy* / Q000378:metabolism; D041743:Herb-Drug Interactions; D006801:Humans; D009498:Neurotoxins / Q000009:adverse effects / Q000378:metabolism; D008517:Phytotherapy / Q000379:methods*; D028321:Plant Preparations / Q000009:adverse effects* / Q000493:pharmacokinetics* / Q000627:therapeutic use; D010946:Plants, Medicinal / Q000009:adverse effects / Q000737:chemistry / Q000378:metabolism; D012640:Seizures / Q000139:chemically induced* / Q000378:metabolism
D018435:ATP Binding Cassette Transporter, Subfamily B; D000927:Anticonvulsants; D009498:Neurotoxins; D028321:Plant Preparations; D003577:Cytochrome P-450 Enzyme System