digoxin and Epilepsy

The product of the ABCB1 gene, P-glycoprotein (PGP), is a transmembrane active efflux pump for a variety of drugs. It is a putative mechanism of multidrug resistance in a range of diseases. It is postulated that ABCB1 polymorphisms contribute to variability in PGP function, and that therefore multidrug resistance is, at least in part, genetically determined. However, studies of ABCB1 genotype or haplotype and PGP expression, activity or drug response have produced inconsistent results. This critical review of ABCB1 genotype and PGP function, including mRNA expression, PGP-substrate drug pharmacokinetics and drug response, highlights methodological limitations of existing studies, including inadequate power, potential confounding by co-morbidity and co-medication, multiple testing, poor definition of disease phenotype and outcomes, and analysis of multiple drugs that might not be PGP substrates. We have produced recommendations for future research that will aid clarification of the association between ABCB1 genotypes and factors related to PGP activity.

Topics: Animals; Anti-HIV Agents; Antidepressive Agents; ATP Binding Cassette Transporter, Subfamily B; ATP Binding Cassette Transporter, Subfamily B, Member 1; CD4 Lymphocyte Count; Digoxin; Epilepsy; Genotype; Haplotypes; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Immunosuppressive Agents; Kidney; Neoplasms; Organic Anion Transporters; RNA, Messenger

Topics: Administration, Oral; Adrenocorticotropic Hormone; Animals; Anticonvulsants; Bone Marrow; Central Nervous System; Digoxin; Drug Interactions; Epilepsy; Humans; Hydantoins; Hydroxylation; Injections, Intramuscular; Liver; Mice; Rabbits; Rats

Neuroinflammation plays an important role in the pathogenesis of epilepsy, so it is necessary to clarify the influence of standard antiepileptic drugs as well as adjuvant agents (e.g., cardiac glycoside digoxin, which previously showed a clear anticonvulsant potential) on cyclooxygenase pathway and neuron-specific enolase under the conditions of chronic epileptogenesis. The aim of the article is to determine the effect of digoxin, sodium valproate, and celecoxib per se, as well as the combination of digoxin with sodium valproate on the content of cyclooxygenase 1 and 2 types, prostaglandins E2, F2α, I2, thromboxane B2, 8-isoprostane and neuron-specific enolase in the brain of mice in the pentylenetetrazole-induced kindling model. It was found that only the combination of sodium valproate with digoxin provides a complete protective effect (absence of seizures) and shows the clearest influence on neuroinflammation markers and neuronal damage than monotherapy with each of these drugs and celecoxib, which appeared to be an ineffective anticonvulsant. The obtained results indicate that digoxin is a promising adjuvant drug to classical antiepileptic drugs (mostly sodium valproate) in epilepsy treatment.c.

Topics: Animals; Anticonvulsants; Celecoxib; Digoxin; Epilepsy; Mice; Neuroinflammatory Diseases; Pentylenetetrazole; Phosphopyruvate Hydratase; Prostaglandin-Endoperoxide Synthases; Rats; Rats, Wistar; Valproic Acid

Topics: Bipolar Disorder; Digoxin; Epilepsy; Famous Persons; France; History, 19th Century; History, 20th Century; Humans; Medicine in the Arts; Paintings

It has been shown on frogs with epileptogenic focus induced by the injection of penicillin (1000 U in 0.4 ml) into the hippocamp that preinjection (or injection on the background of the functioning epileptogenic focus) of strophanthin (1.8 and 0.18 microgram/g) or digoxin (1.2 micrograms/g) into spinal lymphaticus sac led to a sharp increase in interparoxysmal epileptiform discharges and electrographic correlates of fits on the ECG. The influence of cardiac glycosides upon the epileptized cerebral neurons is thought to be associated with the capacity of these drugs to inhibit Na+, K+-ATPase of neurons and their axons resulting in the disturbance of cerebral mediator activity.

Topics: Animals; Digoxin; Drug Synergism; Epilepsy; Hippocampus; Male; Penicillins; Rana temporaria; Strophanthins

Swallow syncope is an often misdiagnosed rare disorder due to enhanced vagal tone during eating in patients with underlying esophageal and/or cardiac abnormalities. We present three cases of this disorder, one related to digitalis toxicity and the other two with diffuse esophageal spasm. The investigation, differential diagnosis, prognosis and management of swallow syncope are discussed.

Topics: Adult; Deglutition; Diagnosis, Differential; Digoxin; Epilepsy; Esophageal Diseases; Female; Heart Diseases; Humans; Male; Middle Aged; Propantheline; Syncope

Topics: Brain; Digoxin; Electroencephalography; Epilepsy; Female; Humans; Middle Aged; Substance-Related Disorders

Topics: Digoxin; Epilepsy; Erythrocyte Membrane; Erythrocytes; Humans; Phenytoin; Sodium-Potassium-Exchanging ATPase

This report describes a clinical syndrome of arrhythmias that may have neural origin. Two patients presented with episodes of loss of consciousness, disorientation, and paroxysmal supraventricular tachycardia (PSVT). One patient reported experiencing neurologic symptoms without tachycardia. When electrophysiologic testing with intracardiac recordings and programmed stimulation yielded no abnormalities that could account for the arrhythmias, a primary neurologic abnormality was sought. The electroencephalograms of both patients showed epileptiform discharges that supported this hypothesis. Arrhythmias and neurologic symptoms were controlled by treatment with the antiepileptic drug carbamazepine in one patient. Findings in these two patients suggest that in some patients arrhythmias may be a manifestation of seizures.

Topics: Adolescent; Adult; Arrhythmias, Cardiac; Carbamazepine; Digoxin; Electroencephalography; Electrophysiology; Epilepsy; Humans; Male; Phenytoin; Tachycardia, Paroxysmal

Topics: Aged; Amobarbital; Digoxin; Epilepsy; Female; Humans; Nerve Crush; Pacemaker, Artificial; Phenobarbital; Phenytoin; Phonocardiography; Phrenic Nerve