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Citation
Tags
HERO ID
7281866
Reference Type
Journal Article
Subtype
Review
Title
Drug treatments in patients with cardiac diseases and epilepsy
Author(s)
Zaccara, G; Lattanzi, S; Cincotta, M; Russo, E
Year
2020
Is Peer Reviewed?
Yes
Journal
Acta Neurologica Scandinavica
ISSN:
0001-6314
EISSN:
1600-0404
Volume
142
Issue
1
Page Numbers
37-49
Language
English
PMID
32259277
DOI
10.1111/ane.13249
Web of Science Id
WOS:000527401100001
Abstract
OBJECTIVE:
Comorbidity between epilepsy and heart diseases is frequent.
METHODS:
All drugs classified within the group of drugs for cardiovascular system according to the Anatomical Therapeutic Chemical (ATC) classification system were reviewed for their effects on seizures or epilepsy.
RESULTS:
Several agents showed antiseizure properties in animal models of seizures and/or in patients with epilepsy and only few were proconvulsant. Drugs with anticonvulsant effects include mecamylamine and guanfacine (antihypertensive drugs), indapamide, amiloride, furosemide and bumetanide (diuretics), fasudil (peripheral vasodilator), bioflavonoids (vasoprotective drug), propranolol (beta blocking agent), isradipine, nimodipine, verapamil and diltiazem (calcium channel blockers: CCBs), fosinopril and zofenopril (agents acting on the renin-angiotensin system), several statins, and fenofibrate (lipid-modifying agents). Drugs with proconvulsant properties in experimental models or in patients include reserpine, buflomedil, naftidrofuryl, and clonidine and propranolol at high doses. Drug-drug interactions (DDI) between antiseizure medications (ASMs) and drugs for cardiovascular system were also searched in two leading publicly accessible drug compendia. The most important DDIs occur between enzyme-inducing (EI) ASMs and ivabradine, ranolazine, macitenan and between EI-ASMs and the CCBs felodipine, nicardipine, nisoldipine, and verapamil. Simvastatin and atorvastatin are the lipid-modifying agents with more DDIs with EI-ASMs. Several pharmacodynamic interactions have been also documented.
DISCUSSION AND CONCLUSIONS:
Available data show that the treatment of patients with epilepsy and vascular comorbidities is challenging and requires the appropriate knowledge of pharmacological properties of drugs and drug interactions.
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