title: Adjunctive use of verapamil in patients with refractory temporal lobe epilepsy: a pilot study.
abstract: OBJECTIVE
  The present study aimed to determine if adjunctive use of verapamil, as a P-glycoprotein (P-gp) inhibitor, is efficacious in decreasing seizure frequency in patients with refractory temporal lobe epilepsy.
  
  
  METHODS
  This was an open-label pilot study. Adult patients with refractory temporal lobe epilepsy were studied. Baseline seizure type and seizure count were determined. Patients were divided randomly into two groups. Group A received verapamil 120 mg/day (n=13), and group B received 240 mg/day (n=6). All patients were followed for eight weeks. The proportion of responders, which consist of patients with more than 50% reduction in seizure frequency from baseline, was tabulated.
  
  
  RESULTS
  Nineteen patients were studied. Seven patients (36.84%) reached the responder rate. Three patients (50%) in group B were among the responders; two of these patients achieved seizure freedom. Four patients (30.7%) in group A responded favorably to verapamil.
  
  
  CONCLUSIONS
  Developing new means of improving the effectiveness of existing antiepileptic drugs is a desirable way of tackling the dilemma of medically refractory epilepsy. Hypothetically, P-gp inhibitors (e.g., verapamil) might be used to counteract the removal of AEDs from the epileptogenic tissue. Such a strategy was adopted in this non-placebo-controlled, open-label, pilot study. We observed a significant achievement in seizure control associated with adjunctive use of verapamil in patients with refractory temporal lobe epilepsy.
authors: Department of Neurology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, USA. Electronic address: aliasadipooya@yahoo.com.
authors: Ali A
authors: AA
authors: Asadi-Pooya
authors: S Mohammad Ali
authors: SM
authors: Razavizadegan
authors: Alireza
authors: A
authors: Abdi-Ardekani
authors: Michael R
authors: MR
authors: Sperling
mesh_terms: D000293:Adolescent; D000328:Adult; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004833:Epilepsy, Temporal Lobe / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D014700:Verapamil / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D002121:Calcium Channel Blockers; D014700:Verapamil
keywords: P-gp inhibitor; Seizure reduction; Temporal lobe epilepsy; Verapamil