title: The possible use of the L-type calcium channel antagonist verapamil in drug-resistant epilepsy.
abstract: Multidrug transporters (MDTs) are likely to play a role in the pathogenesis of drug resistance in epilepsy, acting at the level of the blood-brain barrier by returning antiepileptic drugs to the blood vessels and lowering brain penetration and concentration (e.g. the so-called multidrug transporter hypothesis). In the last ten years experimental studies on both animal models and human brain tissues have highlighted a potential role of the P-glycoprotein-one of the multidrug transporters of the blood-brain barrier-in the pathophysiology of drug-resistant epilepsies. At the same time, verapamil has been administered to patients with drug-resistant epilepsy (e.g., Dravet syndrome, Lennox-Gastaut syndrome, focal epilepsies) or status epilepticus with promising results. In this drug profile paper the authors review current knowledge and main published studies regarding the role of the L-type calcium channel antagonist verapamil in drug-resistant epilepsy.
authors.affiliation: a Department of Pediatrics, Child Neurology Division , Sapienza University of Rome , Rome , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Nicita
authors.affiliation: a Department of Pediatrics, Child Neurology Division , Sapienza University of Rome , Rome , Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Spalice
authors.affiliation: b Emergency Pediatric Department , "Bambino Gesù" Children's Hospital, IRCCS , Rome , Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Raucci
authors.affiliation: a Department of Pediatrics, Child Neurology Division , Sapienza University of Rome , Rome , Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Iannetti
authors.forename: Pasquale
authors.initials: P
authors.lastname: Parisi
mesh_terms: D000818:Animals; D000927:Anticonvulsants / Q000627:therapeutic use; D000069279:Drug Resistant Epilepsy / Q000188:drug therapy*; D006801:Humans; D023421:Models, Animal; D016896:Treatment Outcome; D014700:Verapamil / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D014700:Verapamil
keywords: P-glycoprotein; Seizures; blood-brain barrier; epilepsy; multidrug transporters; verapamil