آلوپورينول در صرع مقاوم به درمان : كارآزمايي باليني دوسو كور

Allopurinol in refractory epilepsy: A double blind study

Background: Approximately 5-10% of epil epti c patients do not respond to antiepil eptic drugs. Adenosine has an inhibitory effect on the nervous system and its metabolism is prevented as a side effe ct of allopurinol, a xanthine oxidase inhibitor. The current study evaluates the efficacy of allopurinol in intra ctable epilepsy. Methods: In this double-blind case-control clinical trial , of the 38 epileptics with intractable seizures, 18 received 300 mg allopurinol daily and 20 received a placebo as adjuvant treatment to their previous antiepileptic drugs. The patients were first examined two weeks after initiation of the treatment and then monthly for a total of six months, during which they wer e evaluated for seizu re control and possible side effects, Result: Of the 38 participants, 32 patients completed the study, There were significant differences between the two groups in terms of reduction in the total numb er of seizures over the entir e six-month trial. A seizure reduction of 30% observed in 66% of the patients, 50% in 55%, and 60% in 44% of the case s in the allopurinol gro up was ach ieved after two months and persisted throughout the study. Furthermore , a significant difference in seizure dur ation was found between the two groups in month four of the trial. In the allopurino l group , two patients had transi ent rashes, two pati ents had mild nausea, and two experienced dizziness; however, only one patient discontinued the drug due to dizziness. In the placebo group, one pati ent had rash and one had nausea, In additi on , no significant hematological or hepatic changes were found during the trial in eith er group. Conclusions: The results suggest that allopurinol is a safe and effec tive adju vant agent in refr actory epileps y, Based on thi s study, we suggest that purine metabolic path ways and the specifi c use of allopurinol should be further investigated for the treatment of refra ctory epil epsy