Felis ISSN 2398-2950

Therapeutics: anti-epileptics

Contributor(s): Kyle Braund, Hill J, Lauren Trepanier

Anti-epiletics

Drugs to control epilepsy

  • Treatment should not follow a single seizure unless status epilepticus develops: investigation for underlying cause must precede diagnosis of epilepsy Epilepsy: idiopathic.
  • Partial seizures more difficult to control than generalized, but no drug specifically indicated for either condition.
  • Aim to suppress seizures by maintaining effective concentration of drug in the brain, minimizing side-effects.
  • Drugs are mainly lipid soluble, distributed readily to all tissues so plasma levels reflect tissue concentrations.
  • Single drug therapy preferable to multiple; most drugs are liver enzyme inducers   →    enhance metabolism of itself and other drugs.
  • Monitor patient regularly for hepatotoxicity, withdrawal should always be gradual.
  • Phenobarbitone  Phenobarbital  - drug of choice for epilepsy in cats.
  • Diazepam*   Diazepam. Can also be used orally in cats.
  • Potassium bromide  Potassium bromide. Not recommended in cats due to risk of eosinophilic airway disease.

Drugs for status epilepticus

  • Repeated seizures without periods of consciousness    →   emergency requiring prompt treatment or    →   brain damage and death.
  • If cause unknown, administer diazepam*   Diazepam or midazolam  Midazolam both of which cross blood-brain barrier quickly.
  • Solvent (painful on IM injection) and oil-in-water preparations (painful and irritant on IV injection).
  • Alternative: pentobarbitone sodium  Pentobarbital  and phenobarbitone sodium Phenobarbital.

Further Reading

Publications

Refereed papers

  • Recent references from VetMed Resourceand PubMed.
  • Potschka H, Fischer A, Löscher W, Patterson N, Bhatti S, Berendt M, De Risio L, Farquhar R, Long S, Mandigers P, Matiasek K, Muñana K, Pakozdy A, Penderis J, Platt S, Podell M, Rusbridge C, Stein V, Tipold A, Volk H A (2015) International veterinary task force consensus proposal: outcome of therapeutic interventions in canine and feline epilepsy. BMC Vet Res 11, 177 PubMed.

Other sources of information

  • Plumb D C (1999) Veterinary Drug Handbook. 3rd edn. Iowa State University Press, Ames Iowa.


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