Adjunctive Use of Verapamil in Patients With Refractory Temporal Lobe Epilepsy: A Pilot Study

Epilepsy Behav. 2013 Oct;29(1):150-4. doi: 10.1016/j.yebeh.2013.07.006. Epub 2013 Aug 22.

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.

Materials and 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.

Conclusion: 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.

Keywords: P-gp inhibitor; Seizure reduction; Temporal lobe epilepsy; Verapamil.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Calcium Channel Blockers / therapeutic use*
  • Dose-Response Relationship, Drug
  • Epilepsy, Temporal Lobe / drug therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Verapamil / therapeutic use*
  • Young Adult

Substances

  • Calcium Channel Blockers
  • Verapamil