Visualize to Memorize

Excerpt from  Cafer's Mood Stabilizers and Antiepileptic Drugs Topiramate (TOPAMAX)  toh PEER a mate / TOH pah max “Top at max (speed on) Top (of) pyramid” ❖  Antiepileptic   ❖ Voltage-gated sodium and calcium channel blocker    ❖ Glutamate ⇩ FDA approved for:   ❖  Focal seizures   ❖ Bilateral tonic-clonic seizures   ❖ Lenno x-Gastaut syndrome  ❖ Migraine prophylaxis  ❖ Obesity, long-term tx  (in combination with phentermine) Used off label for: ❖ Alcoholism (relapse prevention)  ❖ Bipolar disorder (adjunct)  ❖ Weight loss (monotherapy)  ❖ Binge eating disorder  ❖ PTSD Nightmares Topiramate is prescribed by psychiatrists for several off-label uses. The most compelling data is for preventing alcohol relapse . Although not FDA-approved for alcoholism, it is recommended in the 2015 US Veterans Affairs guidelines for moderate/severe alcohol use disorder.  Nicknamed ...

Excerpt from  Cafer's Mood Stabilizers and Antiepileptics Levetiracetam (KEPPRA)   Pronunciation: LEE ve tye RA se tam / KEP ruh “Levitate Keeper”   ❖ Antiepileptic  ❖ Inhibitor of glutamate release FDA approved for: ❖ Focal seizures (adjunct)  ❖ Juvenile myoclonic epilepsy (adjunct)  ❖ Bilateral tonic-clonic seizures (adjunct) Used off label for:  ❖ Other types of seizures Levetiracetam entered the U.S. market in 2000 as an AED with a novel mechanism of action. It binds SV2A, a synaptic vesicle glycoprotein. This reduces the release of glutamate, the brain’s principal excitatory neurotransmitter, thereby preventing hypersynchronization of epileptiform burst firing. Levetiracetam has become one of the most prescribed medications for the treatment of epilepsy. It is not prescribed by psychiatrists . Advantages of levetiracetam as an AED include efficacy for a broad-spectrum of seizure types, lack of cognitive impairment , and  lac...

Excerpt from  Cafer's Mood Stabilizers and Antiepileptics Zon is amide (ZONEGRAN)  Pronunciation: zoe NIS a mide / ZAHN uh gran “Zone is mighty, Zone is grand” ❖ Antiepileptic  ❖ Voltage-gated sodium channel blocker  ❖ Glutamate ⇩ FDA approved for: ❖ Focal seizures Used off label for:  ❖ Other types of seizures  ❖ PTSD nightmares  ❖ Sleep-related eating disorder  ❖ Obesity  ❖ Binge eating disorder  ❖ Alcohol use disorder  ❖ Migraine prophylaxis  ❖ Parkinsonian symptoms associated with Lewy body dementia Zonisamide (Zonegran) is a broad-spectrum antiepileptic drug (AED) that blocks sodium and calcium channels and increases dopaminergic and serotonergic transmission. It is unrelated to other antiseizure medications.  Zonegran can cause weight loss: Zonisamide decreases appetite and has been shown to decrease binge-eating. Cognitive impairment including “ brain fog ”, confusion, difficulty concentrating, and word-findi...

Excerpt from  Cafer's Mood Stabilizers and Antiepileptics Clobazam (Onfi) “Clob ber On wi- fi ” Pronunciation:  KLOE ba zam / ON fee ❖ 1,5 benzodiazepine ❖ Rapid onset ❖ Long duration ❖ DEA Schedule IV  FDA approved for:  ❖ Seizures of Lennox-Gastaut syndrome (LGS) Clobazam, long available in other countries, was finally FDA approved in the US in 2011 for adjunctive treatment of seizures associated with Lennox-Gastaut Syndrome (ages 2 years or older). Outside of the US it was marketed as an anxiolytic since 1975 and an anticonvulsant since 1984. Lennox-Gastaut syndrome (LGS), pronounced gas-TOE , is a type of childhood-onset epilepsy characterized by a triad of symptoms including multiple seizure types, intellectual impairment, and characteristic EEG findings.  Clobazam is a Schedule IV controlled substance like all of the other benzos.  Alcohol ingestion increases the blood concentration of clobazam by about 50%.  So, what is so special about c...