Status epilepticus (SE) is a serious neurological emergency defined by
prolonged or recurring seizures that frequently do not respond to standard antiepileptic medications.
Recent revelations into the molecular underpinnings of SE, including neuroinflammation,
oxidative stress, angiogenesis, and disruption of the blood-brain barrier, have stimulated research
into targeted therapeutics. Lenvatinib, a multi-kinase inhibitor sanctioned for many cancers,
has demonstrated potential neuroprotective and anti-inflammatory effects by targeting the
VEGFR, FGFR, and PDGFR pathways, which are also involved in epileptogenesis.
This review examines the therapeutic potential of repurposing lenvatinib in the pilocarpine-
induced status epilepticus model, a well-established preclinical framework that simulates
human temporal lobe epilepsy. Preclinical evidence, mechanistic relevance, pharmacodynamics,
blood-brain barrier permeability, and safety profiles were reviewed to determine the
viability of lenvatinib as an adjunct or alternative therapy.
Furthermore, the function of angiogenic signaling in the advancement of seizures and
how lenvatinib's multitargeted mechanism may influence critical pathogenic pathways were also
examined.
Although existing evidence is insufficient, in silico and in vivo investigations indicate
that lenvatinib may disrupt neuroinflammatory and vascular alterations essential to SE
pathogenesis. Additional preclinical validation is necessary to verify its efficacy and safety.
This review seeks to establish a thorough basis for subsequent research on the repurposing
of lenvatinib in neurotherapeutics.
V. B., Asha Nayak, D. L.M. et al.· Current Signal Transduction...· 0 citations
Phenytoin, an antiepileptic drug known for its complex
pharmacokinetics and narrow therapeutic range, may interact with garlic (Allium sativum).
Garlic affects CYP450 enzymes and P-glycoprotein, potentially affecting the metabolism,
transport, efficacy, and toxicity of phenytoin. This systematic review aims to
assess the existing evidence regarding pharmacokinetic and pharmacodynamic interactions
between garlic and phenytoin.
A thorough literature review was performed utilizing PubMed, Scopus, Web of
Science, ScienceDirect, and Google Scholar. Relevant research was examined and integrated
in accordance with PRISMA criteria to present a summary of existing knowledge.
Data from in vitro studies, animal models, and restricted clinical reports were examined to
evaluate the influence of garlic on phenytoin absorption, metabolism, plasma levels, and
treatment effectiveness. Mechanistic findings, heterogeneity in garlic formulations, and
therapeutic implications for epilepsy management were also examined.
In vitro and pharmacokinetic studies indicate that garlic may either increase or
inhibit the metabolism of phenytoin. However, conclusive determinations cannot be
drawn owing to the lack of substantial human research.
Available findings suggest a potential interaction between garlic and phenytoin
involving CYP450 enzymes and P-glycoprotein. However, inconsistent experimental
outcomes and inadequate clinical evidence prevent definitive conclusions. The variability
of garlic formulations hampers interpretation, highlighting the necessity for careful clinical
application and rigorously planned human trials in epilepsy management.
Clinicians should exercise vigilance and systematically inquire about garlic
consumption in patients undergoing phenytoin therapy. Controlled clinical trials are necessary
to validate these findings and ascertain the safety of garlic in combination with
phenytoin.
D. Lm, Asha Nayak, Vaishnavi B et al.· Current Pharmacogenomics and...· 0 citations
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