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 PubMed and VetMedResource.
  • Potschka H, Fischer A, Löscher W et al (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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