Catamenial Epilepsy Treatment

Timothy Welty, PharmD

Status and phase: Unknown; Phase 2

Conditions: Epilepsy

Treatments: Drug: Keishibukuryogan; Drug: AED treatment plus placebo

Study type: Interventional

Funder types: Other

Identifiers

NCT01299870

12416

Details and patient eligibility

About

Epilepsy is a disorder in the brain. The brain is full of "nerve" cells. Nerve cells have normal electrical activity to control the many functions of the body. Sometimes nerve cells do not function normally due to many different reasons such as disease, an injury or because the brain didn't develop normally at birth. When nerve cells do not function normally the electrical activity that controls things like muscles and body movement can get mixed up and cause seizures. When a seizure occurs, sometimes a person loses control of body movement, and/or bodily functions. When a seizure occurs, a person may become unconscious, and/or senses may be affected. Seizures can occur at any time, without warning, and can lead to many health problems.

"Catamenial epilepsy" is specific form of epilepsy in women. It is closely related to the menstrual cycle. In this form of epilepsy seizures increase around the menstrual period.

By doing this study, researchers hope to learn whether Keishibukuryogan add-on therapy with antiepileptic drugs is safe for women with epilepsy.

Full description

It is known that the female hormone levels in epilepsy patients are different from healthy women. These hormonal differences may be part of the cause of catamenial epilepsy. It is estimated that at least 1 in every 3 women with epilepsy have catamenial epilepsy. Although many antiepileptic drugs are available, it is very difficult to control these seizures. In the past, studies using antiepileptic drugs and hormonal agents were done to treat catamenial epilepsy. However, those medications did not work well and caused side effects.

Keishibukuryogan is a traditional Japanese herbal medication. It is made of 5 natural herbs (cinnamon bark, hoelen, moutan bark, peony root, and peach kernel). It is used to treat disorders in women like menopause and menstrual cycle problems. This is the first study to examine the safety of Keishibukuryogan in women with epilepsy. As such, Keishibukuryogan and your current antiepileptic drug(s) will be given to you during the study.

Keishibukuryogan is a dietary supplement in the United States. It can be bought without a prescription. The safety and efficacy of Keishibukuryogan has not been studied in epilepsy. However, it has been used safely in Japan and other Asian countries for years.

Enrollment: 17 estimated patients

Sex: Female

Ages: 21 to 45 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria

1. Female with a positive diagnosis of epilepsy, and

2. Women with epilepsy (WWE) patients who have seizures and treated with AEDs and no dosage changes in the past 30 days, and

3. WWE patients with regular menstrual period with range of 28 ± 7 days.

4. WWE patients with age range between 21 and 45 years old.

5. WWE patients who are willing and able to give signed informed consent form are eligible to participate in this study.

6. WWE who agree to use non-hormonal forms of contraception for the duration of this study.

   No hormonal Intra-Uterine Device is allowed for the duration of this study.

7. Patients with a history of cancer must be in remission for at least 5 years.

Exclusion Criteria

1. History of status epilepticus in the last 12 months
2. Current diagnosis of polycystic ovary syndrome and/or endometriosis
3. Pregnant or breast feeding
4. Allergy to any ingredients in KBG (cinnamon, hoelen, moutan bark, peony root, or peach kernel)
5. Patients who are receiving warfarin and/or antiplatelet drugs
6. Severe cardiovascular, renal or hepatic impairment (i.e., coronary heart disease, myocardial infarction, renal failure, hepatitis) or history of those diseases
7. Any other unstable diseases (e.g., mental disease, infection, cancer)
8. Lab values at screening phase showing 1.5 times above the upper range of normal
9. Patients who are receiving phenytoin will be excluded (since a potential interaction between phenytoin and peony root was reported)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Double Blind

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17 participants in 2 patient groups

AED treatment plus placebo

Active Comparator group

Treatment:

Drug: AED treatment plus placebo

Keishibukuryogan

Experimental group

Treatment:

Drug: Keishibukuryogan