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| content:cenobamate [2024/03/19 13:37] – created biju.hameed@gmail.com | content:cenobamate [2024/03/19 15:48] (current) – [Mechanism of Action] biju.hameed@gmail.com |
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| Cenobamate (CNB) is a new Anti Seizure Medicine (ASM) recently approved by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for the treatment of focal-onset seizures in adults. CNB is not approved for use in children and adolescents. | Cenobamate (CNB) is a new Anti Seizure Medicine (ASM) recently approved by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for the treatment of focal-onset seizures in adults. CNB is not approved for use in children and adolescents. |
| ==== Mechanism of Action ==== | ==== Mechanism of Action ==== |
| * The precise mechanism if unknown[(:cite:pmid33993416>{{pmid>long:33993416}})] | * The precise mechanism is unknown[(:cite:pmid33993416>{{pmid>long:33993416}})] |
| * reduce repetitive neuronal firing by blocking excitatory currents by promoting the inactivated state of voltage-gated sodium channels | * reduce repetitive neuronal firing by blocking excitatory currents by promoting the inactivated state of voltage-gated sodium channels |
| * enhance inhibitory currents at GABAA receptors | * enhance inhibitory currents at GABAA receptors |
| * Positive allosteric modulator of GABA-A ion channel[(:cite:pmid32325146>{{pmid>long:32325146}})] | * Positive allosteric modulator of GABA-A ion channel[(:cite:pmid32325146>{{pmid>long:32325146}})] |
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| Makridis et al[(:cite:pmid35937072>{{pmid>long:35937072}})] reported their experience with CNB in 16 pediatric patients with Drug Resistant Epilepsy (DRE). CNB was initiated in pediatric patients at 12.5 mg once a day (0.22 mg/kg/d) and then titrated-up by 0.47 ± 0.27 mg/kg/d every 2 weeks.Treatment with CNB resulted in seizure-free or a significant seizure reduction of > 50% in more than two thirds of their patients. The rates of seizure freedom or strong reduction of seizure frequency were in line with data published for adults. No serious adverse events occurred in their cohort. | Makridis et al[(:cite:pmid35937072>{{pmid>long:35937072}})] reported their experience with CNB in 16 pediatric patients with Drug Resistant Epilepsy (DRE). CNB was initiated in pediatric patients at 12.5 mg once a day (0.22 mg/kg/d) and then titrated-up by 0.47 ± 0.27 mg/kg/d every 2 weeks.Treatment with CNB resulted in seizure-free or a significant seizure reduction of > 50% in more than two thirds of their patients. The rates of seizure freedom or strong reduction of seizure frequency were in line with data published for adults[(:ref:todo)]. No serious adverse events occurred in their cohort. |
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| Most frequent adverse effects in their cohort were somnolence/fatigue which occurred during up-titration, in line with other reports[(:cite:pmid32396252>{{pmid>long:32396252}})]. Less frequently vertigo, nausea, balance disorder, diplopia, increased impulsive/agitated behavior, increased appetite with weight gain and impaired sleep quality were reported. | Most frequent adverse effects in their cohort were somnolence/fatigue which occurred during up-titration, in line with other reports[(:cite:pmid32396252>{{pmid>long:32396252}})]. Less frequently vertigo, nausea, balance disorder, diplopia, increased impulsive/agitated behavior, increased appetite with weight gain and impaired sleep quality were reported. |
